ABSTRACT
A strong initial inflammatory response is important in neuroborreliosis. Since complement is a main player in early inflammation, we monitored the concentration and activation of complement in plasma and cerebrospinal fluid from 298 patients, of whom 23 were diagnosed with neuroborreliosis. Using sandwich ELISAs, we found significantly elevated levels of C1q, C4, C3, and C3a in cerebrospinal fluid, but not in plasma, in patients with neuroborreliosis. This finding indicates that complement plays a role in the human immune response in neuroborreliosis, that the immunologic process is compartmentalized to the CNS, and that complement activation may occur via the classical pathway.
Subject(s)
Central Nervous System/immunology , Complement Activation , Complement C1q/cerebrospinal fluid , Complement C3/cerebrospinal fluid , Lyme Neuroborreliosis/cerebrospinal fluid , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Lyme Neuroborreliosis/immunology , Lyme Neuroborreliosis/pathology , Male , Middle Aged , Statistics, NonparametricABSTRACT
Tick-borne encephalitis, TBE, has been observed in Aland Islands (population 26,500) for more than 60 years. Because of the small population, the relative incidence is high. Antibodies to TBE virus have been found in ca. 5% of healthy blood donors, indicating that subclinical infection must be common. This study is a review of the symptoms and signs of all the 301 serologically verified cases of TBE seen in Aland during 1959-2005. It also aims at analysing any possible changes in the symptoms and signs of TBE over time. The annual number of patients has been from 1 to 26, and has increased over time. The clinical picture has not undergone any conspicuous changes during these years. A few patients have had permanent neurological damage. There were no certain deaths from TBE. Simple practical measures may be taken to diminish, but not to eliminate, the risk of tick bites. Vaccination of exposed people is recommended, and general vaccination against TBE has commenced in Aland, beginning 2006. This is expected to reduce the incidence of TBE among the population to almost nil, provided that new inhabitants are vaccinated and that booster vaccinations are carried out as required.
Subject(s)
Encephalitis, Tick-Borne/complications , Encephalitis, Tick-Borne/epidemiology , Endemic Diseases/prevention & control , Adolescent , Adult , Aged , Antibodies, Viral/blood , Child , Child, Preschool , Disease Reservoirs/virology , Encephalitis Viruses, Tick-Borne/immunology , Encephalitis, Tick-Borne/prevention & control , Finland/epidemiology , Humans , Infant , Male , Mass Vaccination , Middle Aged , Retrospective Studies , SeasonsABSTRACT
Erythema migrans is the most common manifestation of stage I Lyme borreliosis. This study investigated the relation between the subspecies of Borrelia burgdorferi involved, the time of development and the appearance of the manifestation. The study comprised 33 cases of erythema migrans yielding B. burgdorferi sensu lato by culture of skin biopsy. The species was determined by polymerase chain reaction analysis of the cultivated spirochaetes. In 22 of the cases, B. afzelii was demonstrated, whereas 11 yielded growth of B. garinii. All 11 erythemas associated with B. garinii were homogeneous, whereas 20 of the 22 associated with B. afzelii were annular. The garinii erythemas developed more rapidly, and were generally larger than the afzelii erythemas. The observations call for comparison with other geographical areas with similar, and with different, borrelial infection spectra.
