Journal Article

Higher mRNA Levels of Chemokines and Cytokines Associated with Macrophage Activation in Erythema Migrans Skin Lesions in Patients from the United States than in Patients from Austria with Lyme Borreliosis

Kathryn L. Jones, Robert R. Muellegger, Terry K. Means, Marshall Lee, Lisa J. Glickstein, Nitin Damle, Vijay K. Sikand, Andrew D. Luster and Allen C. Steere

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 1, pages 85-92
Published in print January 2008 | ISSN: 1058-4838
Published online January 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/524022
Higher mRNA Levels of Chemokines and Cytokines Associated with Macrophage Activation in Erythema Migrans Skin Lesions in Patients from the United States than in Patients from Austria with Lyme Borreliosis

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Background. Erythema migrans (EM) is caused primarily by Borrelia afzelii in Europe and solely by Borrelia burgdorferi in the United States. B. burgdorferi infection in the United States has previously been associated with faster expansion of EM lesions and with more associated symptoms, compared with B. afzelii infection in Europe. However, reasons for these differences are not yet known.

Methods. We determined the Borrelia species infecting 67 US or Austrian patients with EM. The clinical pictures and chemokine and cytokine mRNA levels in lesional skin were then compared in the 19 B. burgdorferi—infected US patients and the 37 B. afzelii—infected Austrian patients, the 2 largest groups.

Results. The 19 B. burgdorferi—infected US patients had faster-expanding EM lesions and a median of 4 associated signs and symptoms, whereas the 37 B. afzelii—infected Austrian patients had slower-expanding lesions and usually did not experience associated symptoms. Compared with the EM lesions of B. afzelii—infected Austrian patients, those of B. burgdorferi—infected US patients had significantly higher mRNA levels of chemokines associated with activation of macrophages, including chemoattractants for neutrophils (CXCL1), macrophages (CCL3 and CCL4), and T helper 1 cells (CXCL9, CXCL10, and CXCL11). In addition, compared with the EM lesions of Austrian patients, the EM lesions of US patients tended to have higher mRNA levels of the macrophage-associated proinflammatory cytokines interleukin 1β and tumor necrosis factor β.

Conclusions. The EM lesions of B. burgdorferi—infected US patients expanded faster, were associated with more symptoms, and had higher mRNA levels of macrophage-associated chemokines and cytokines than did the EM lesions of B. afzelii—infected Austrian patients.

Journal Article.  4803 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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