Borrelia burgdorferi in the central nervous system: experimental and clinical evidence for early invasion

Article Abstract:

Lyme disease is caused by the spirochete Borrelia burgdorferi (BB), and is transmitted by the bite of the deer tick, Ixodes dammini. The disease affects many different organ systems in a somewhat sequential, but not always clear-cut pattern. A circular, expanding rash and flu-like symptoms, including a stiff neck, may appear days or weeks after the tick bite (stage I). Cardiac symptoms and neurologic problems manifesting as facial paralysis and a meningitic (brain inflammation) syndrome may appear after several weeks or months (stage II). This stage responds to antibiotic treatment. Last to appear, months to years later, severe arthritis and central nervous system (CNS) involvement become apparent (stage III). The blood-brain barrier (BBB; a physical separation between brain tissue and the blood consisting of the walls of blood vessels and membranes) usually protects the central nervous system from microbial invasion. The mechanisms that permit bacterial breach of the BBB are not clearly understood. It is suggested that as a result of overwhelming bacterial infection of the blood (bacteremia), microbial factors are produced and initiate an inflammatory process, allowing bacterial intrusion. Suspensions of both killed and live spirochetes were inoculated into the tail vein and into the cisterna magna, a cavity within the brain, of adult Lewis rats. Blood and cerebrospinal fluid (CSF) samples were taken periodically and the BBB permeability changes measured by the increase of radioactive iodinated albumin in CSF compared with parallel blood samples. The results indicating early CNS invasion by Borrelia are supported by the clinical evidence of the detection of BB antigens in the CSF of cases with early Lyme disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Diagnosis, Complications and side effects, Development and progression, Central nervous system, Relapsing fever

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A specific and sensitive assay for the Lyme disease spirochete Borrelia burgdorferi using the polymerase chain reaction

Article Abstract:

Lyme disease is a multisystem disease caused by the spirochete Borrelia burgdorferi. It is transmitted primarily by way of bites from ticks of the Ixodes ricinus complex (I. dammini in the Eastern United States). The symptoms of the disease vary widely from case to case and between the various stages of the disease. Following the tick bite a distinct rash, erythema migrans, may or may not develop. Later manifestations of the illness include severe neurologic, arthritic and occasionally cardiac problems. Therapeutic intervention with oral, and later intravenous antibiotics, if necessary, is usually successful. Diagnosis, in the absence of the usual evidence of bite, rash, or other confirming evidence, is not straightforward. It would therefore be useful to have a means of detecting the presence of the organism. A particular DNA sequence present in all strains of B. burgdorferi has been identified. Using the polymerase chain reaction (PCR), a highly accurate test for the presence of the spirochete is described. The DNA sequence was evident in all B. burgdorferi strains, but not in a closely related species, B. hermsii. The assay detected the DNA sequence in 17 out of 18 strains examined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Genetic aspects, Borrelia burgdorferi, Spirochetes

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