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Acute febrile illness after tick bites may be caused by various agents (e.g., Borrelia spp., tick-borne encephalitis virus, Babesia spp., Rickettsia spp., Neoehrlichia mikurensis, Anaplasma phagocytophilum). Spiroplasma ixodetis was initially [...]

Lyme neuroborreliosis (LNB) is a complex neuroinflammatory disorder caused by Borrelia burgdorferi , which is transmitted through tick bites. Epigenetic alterations, specifically DNA methylation (DNAm), could play a role in the host immune response during infection. In this study, we present the first genome-wide analysis of DNAm in peripheral blood mononuclear cells from patients with LNB and those without LNB. Using a network-based approach, we highlighted HLA genes at the core of these DNAm changes, which were found to be enriched in immune-related pathways. These findings shed light on the role of epigenetic modifications in the LNB pathogenesis that should be confirmed and further expanded upon in future studies. [ABSTRACT FROM AUTHOR]

Borrelia miyamotoi is the cause of an emerging disease in the Northern Hemisphere, transmitted by hard (Ixodes) ticks. The bacterial species, described in Japan in 1995 (1), is genetically related [...]

Objectives: Lyme serology does not readily discriminate an active Lyme borreliosis (LB) from a previous Borrelia infection or exposure. Here, we aimed to investigate a large number of immunological protein biomarkers to search for an immunological pattern typical for active LB, in contrast to patterns found in healthy blood donors, a proportion of whom were previously exposed to Borrelia. Methods: Serum samples from well-characterised adult patients with ongoing LB and healthy blood donors were included and investigated using a proximity extension assay (provided by Olink®) by which 92 different immune response-related human protein biomarkers were analysed simultaneously. Results: In total, 52 LB patients and 75 healthy blood donors were included. The blood donors represented both previouslyBorreliaexposed (n = 34) and not exposed (n = 41) based on anti-Borreliaantibody status. Ten of the examined 92 proteins differed between patients and blood donors and were chosen for further logistic regression (p<0.1). Six proteins were statistically significantly different between LB patients and blood donors (p<0.05). These six proteins were then combined in an index and analysed using receiver-operating-characteristic curve analysis showing an area under the curve of 0.964 (p<0.001). Conclusions: The results from this study suggest that there is an immunological protein pattern that can distinguish a present Borrelia infection from a previous exposure as well as anti-Borrelia antibody negative blood donors. Although this method is not adapted for routine clinical use at this point, the possibility is interesting and may open new diagnostic opportunities improving the laboratory diagnostics of LB. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies indicate that successful resolution of Lyme neuroborreliosis (NB) is associated with a strong T helper (Th) 1-type cytokine response in the cerebrospinal fluid (CSF) followed by a down-regulating Th2 response, whereas the role of the recently discovered Th17 cytokine response is unknown. Methods To investigate the relative contribution of different Th associated cytokine/chemokine responses, we used a multiple bead array to measure the levels of CXCL10 (Th1 marker), CCL22 (Th2 marker), IL-17 (Th17 marker) and CXCL8 (general inflammation marker), in serum and in CSF from untreated patients with confirmed NB (n = 133), and non-NB patients (n = 96), and related the findings to clinical data. Samples from patients with possible early NB (n = 15) and possible late NB (n = 19) were also analysed, as well as samples from an additional control group with orthopaedic patients (n = 17), where CSF was obtained at spinal anaesthesia. Results The most prominent differences across groups were found in the CSF. IL-17 was elevated in CSF in 49% of the patients with confirmed NB, but was not detectable in the other groups. Patients with confirmed NB and possible early NB had significantly higher CSF levels of CXCL10, CCL22 and CXCL8 compared to both the non-NB group and the control group (p < 0.0001 for all comparisons). Patients in the early NB group, showing a short duration of symptoms, had lower CCL22 levels in CSF than did the confirmed NB group (p < 0.0001). Furthermore, patients within the confirmed NB group showing a duration of symptoms Borrelia-antibodies. Conclusion Our results support the notion that early NB is dominated by a Th1-type response, eventually accompanied by a Th2 response. Interestingly, IL-17 was increased exclusively in CSF from patients with confirmed NB, suggesting a hitherto unknown role for Th17 in NB. However, for conclusive evidence, future prospective studies are needed.

Lyme borreliosis (LB), caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex, is the most common tick-borne infection in Europe. Laboratory diagnosis of LB is mainly based on the patients' medical history, clinical signs and symptoms in combination with detection of Borrelia-specific antibodies where indirect enzyme-linked-immunosorbent assay (ELISA) is the most widely used technique. The objective of the study was to evaluate and compare the diagnostic accuracy (sensitivities and specificities) of serological tests that are currently in use for diagnosis of LB in clinical laboratories in Northern Europe, by use of a large serum panel. The panel consisted of 195 serum samples from well-characterized and classified patients under investigation for clinically suspected LB (n = 59) including patients with Lyme neuroborreliosis, Lyme arthritis, acrodermatitis chronica atrophicans, erythema migrans or other diseases (n = 112). A total of 201 serum samples from healthy blood donors were also included. The panel (396 serum samples altogether) was sent to 12 clinical laboratories (using five different ELISA methods) as blinded for group affiliation and the laboratories were asked to perform serological analysis according to their routine procedure. The results from the study demonstrated high diagnostic concordance between the laboratories using the same diagnostic assay and lower diagnostic concordance between laboratories using different diagnostic assays. For IgG, the results were in general rather homogenous and showed an average sensitivity of 88% (range 85–91%) compared to IgM which showed lower average sensitivity of 59% (range 50–67%) and more heterogeneous results between assays and laboratories. [ABSTRACT FROM AUTHOR]

The article comments on a study which evaluated the diagnostic utility of CXCL13, a B-cell chemoattractant, in lyme neuroborreliosis (LNB). A comparison between the presentations of LNB in North American and European patients is discussed. The primary criteria for the diagnosis of LNB include the presence of clinical signs and symptoms suggestive of LNB, cerebrospinal fluid (CSF) pleocytosis and borrelia intrathecal antibody synthesis (ITAbs). The diagnostic benefits of CXCL13 are described.

A rapid and reliable influenza method is important to meet diagnostic needs. Here, the performance of the cartridge-based Xpert Flu assay was evaluated in comparison with an in-house real-time PCR method. Analysis was then decentralized from the clinical microbiology laboratory located at County Hospital Ryhov, Jönköping, Sweden, to the clinical chemistry laboratories present at the three hospitals in Region Jönköping County, allowing a 24/7 service. In total, 189 clinical samples were included in 2014–2015. The overall sensitivity and specificity of Xpert Flu were both 99%. With Xpert Flu and the 24/7 service the median turn-around time from sampling to available test result decreased from 22 h in 2013 to 1.9 h in 2015. In summary, the analytical performance of Xpert Flu is excellent. The large degree of automation of GeneXpert and Xpert Flu with assay on demand has allowed a 24/7 service at the clinical chemistry laboratories in the county, and a significantly reduced turn-around time, which is valuable for both patients and the healthcare providers. [ABSTRACT FROM PUBLISHER]