The Lyme Disease Network
Medical / Scientific Abstract

Title:Association of antibiotic treatment-resistant Lyme arthritis with T cell responses to dominant epitopes of outer surface protein A of Borrelia burgdorferi [see comments]
Authors:Chen J, Field JA, Glickstein L, Molloy PJ, Huber BT, Steere AC
Source:Arthritis Rheum 1999 Sep;42(9):1813-22
Organization:Tufts University School of Medicine, Boston, Massachusetts, USA.

OBJECTIVE: To explore further the association of antibiotic treatment-resistant Lyme arthritis and T cell reactivity with outer surface protein A (OspA) of Borrelia burgdorferi, including the identification of T cell epitopes associated with this treatment-resistant course. METHODS: The responses of peripheral blood and, if available, synovial fluid lymphocytes to B burgdorferi proteins, fragments, and synthetic peptides, as determined by proliferation assay and interferon-gamma production, were compared in 16 patients with treatment-responsive and 16 with treatment-resistant Lyme arthritis. RESULTS: The maximum severity of joint swelling correlated directly with the response to OspA. Moreover, the only significant difference between patients with treatment-resistant and treatment-responsive arthritis was in reactivity with N-terminal and C-terminal fragments of OspA, OspA1 (amino acids [aa] 16-106), and OspA3 (aa 168-273). Epitope mapping showed that 14 of the 16 patients with treatment-resistant arthritis had responses to OspA peptides (usually 4 or 5 epitopes), whereas only 5 of the 16 patients with treatment-responsive arthritis had reactivity with these peptides (usually 1 or 2 epitopes) (P = 0.003). Patients with HLA-DRB1 alleles associated with treatment-resistant arthritis were more likely to react with peptide 15 (aa 154-173) and, to a lesser degree, with peptide 21 (aa 214-233) than patients with other alleles, whereas the responses to other epitopes were similar in both groups. CONCLUSION: The maximum severity of joint swelling and the duration of Lyme arthritis after antibiotic treatment are associated with T cell responses to specific epitopes of OspA.

Adolescence, Adult, Aged, Alleles, Antibiotics, Tetracycline, THERAPEUTIC USE, Antibody Formation, Antigens, Surface, IMMUNOLOGY, Bacterial Outer Membrane Proteins, IMMUNOLOGY, Bacterial Vaccines, IMMUNOLOGY, Borrelia burgdorferi, Child, Doxycycline, THERAPEUTIC USE, Drug Resistance, Microbial, IMMUNOLOGY, Epitope Mapping, Epitopes, T-Lymphocyte, DRUG EFFECTS, Female, Human, HLA Antigens, GENETICS, Immunodominant Epitopes, IMMUNOLOGY, Lyme Disease, DRUG THERAPY, IMMUNOLOGY, Male, Middle Age, Severity of Illness Index, Support, Non-U.S. Gov't, Support, U.S. Gov't, P.H.S., T-Lymphocytes, IMMUNOLOGY, Tetracycline Resistance, IMMUNOLOGY, Time Factors

Language: Eng

Unique ID: 99441952

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