INTERLEUKINS DYNAMIC IN PATIENTS WITH LYME BORRELIOSIS
Introduction. Lyme borreliosis (LB) is a transmissible, naturally occurring bacterial disease caused by pathogenic borrelia, transmitted by ticks of the genus Ixodes, characterized by polymorphism of clinical symptoms. Virulence factors of B. burgdorferi surface Osp proteins activate macrophages, dendritic cells, T and B lymphocytes, which secrete specific substances of the protein nature – cytokines. The latter perform a mediating function by transmitting signals between interacting cells. The study of the activity dynamics of pro-inflammatory and anti-inflammatory cytokines allows us to elucidate new links in the immunopathogenesis of borrelia infection.
The aim of the study – to investigate the dynamics of the pro-inflammatory cytokines IL-1β, TNF-α, IL-6 and anti-inflammatory IL-10 in the serum of patients with erythematous form of Lyme borreliosis, depending on the disease course.
Research Methods. 83 individuals aged from 18 to 70 years with erythematous form of Lyme borreliosis (LB) were observed. There were 35 men (42.2 %), 48 women (57.8 %). The average age of the surveyed was (42.65±13.91) years. The patients were divided into three groups: group 1 (1) – 38 (45.7 %) persons with acute course of LB (up to 3 months); group 2 (2) – 32 patients (38.6 %) with subacute (from 3 to 6 months); group 3 (3) – 13 (15.7 %) patients with chronic course of the disease (more than 6 months). Antibodies to B. burgdorferi s. l. IgM and/or IgG were determined by ELISA. The level of cytokines (TNF-α, IL-1β, IL-6 and IL-10) in the serum of patients was determined by ELISA with using test systems produced by CJSC Vector-Best.
Results and Discussion. At the acute course of Lyme-borreliosis in the serum of patients increases the level of pro-inflammatory IL-1β, TNF-α and IL-6, compared with the control group (p˂0,005), increases the content of anti-inflammatory IL-10 relative to the level in healthy individuals (p˂0,005). In patients with subacute LB, the pro-inflammatory IL-1β content was unchanged, and TNF-α concentration was higher than at acute course (p<0.05) and in control (p<0.005). The level of anti-inflammatory IL-10 in these individuals was lower than in patients with acute course of LB (p>0.05), but significantly higher than in healthy persons (p<0.005). In individuals with circular erythema migrans noted after 6 months and longer, IL-1β content is not increase, TNF-α levels were slightly higher than those with acute course (p>0.05), and IL-6 concentration was significantly higher relative to those with subacute disease, not significantly differs of indices in patients with acute LB.
Conclusions. One of five patients with circular erythema migrans was unable to indicate a tick bite. Elevated IL-10 level in the serum of patients with LB on the background of a high content of pro-inflammatory cytokines may indicate that there is no prerequisite for the transition of the infectious process to the stage of limiting inflammation and may be an indication for immediate administration of etiotropic treatment or replacement of one antibiotic to another.
Sharyfullyna, L.D., & Murzabaeva R.T. (2017). Znachenye immunotsytokinovykh narusheniy v patogeneze iksodovykh kleshchevykh borreliozov [Importance of immune and cytokine disorders in pathogenesis of ixodic tick-borne borreliosis]. Medytsynskiy vestnyk Bashkortostana – Bashkortostan Medical Journal, 12, 1 (67) [in Russian].
Skrypchenko, N.V., & Balynova, A.A. (2012). Sovremennye predstavleniya o patogeneze iksodovykh kleshchevykh borreliozov [Current knowledge of Lyme disease’s pathogenesis]. Zhurnal infektologii – Journal of Infectology, 4, 2, 5-14 [in Russian].
Mynoranskaya, N.S., Uskov, A.N., & Sarap, P.V. (2014). Znachenye immunnogo statusa dlya prognoza khronizatsii borrelioznoy infektsii. Zhurnal infektologii – Journal of Infectology, 6 (1), 35-40 [in Russian].
Ilyinskikh, E.N., Semenov, A.G., Ilyinskikh, I.N., & Cherednikova, E.A. (2011). Prolyferatyvnyy otvet produktsiya immunotsytokinov mononuklearnymi kletkami peryferycheskoy krovi u bolnykh iksodovym kleshchevym borreliozom [Proliferative and cytokine responses of peripheral blood mononuclear cells in Lyme-borreliosis patients]. Immunopatologiya, allergologiya, infektologiya – Immunopathology, Allergology, Infectology, 4, 48-53 [in Russian].
Sarksian, D.S. (2015). Iksodovye kleshchevye borrelyozu – sovremennoe sostoianye problemy [Ixodes tick borreliosis – current state of problem]. Infektsionnyye bolezni – Infectious Diseases, 13 (2), 61-67 [in Russian].
Yarilin, A.A. (2010). Immunologiya: uchebnik [Immunology: a textbook]. Moscow: GEOTAR-Media [in Russian].
Naj, X., & Linder, S. Actin-dependent regulation of Borrelia burgdorferi phagocytosis by macrophages. Curr. Top. Microbiol. Immunol., 16 [Epub ahead of print].
Tokarska-Rodak, M., Pańczuk, A., Kozioł-Montewka, M., Plewik, D., & Szepeluk, A. (2015). Monoinfections caused by borrelia burgdorferi and borrelia burgdorferi / anaplasma phagocytophilum co-infections in forestry workers and farmers. Medycyna Pracy, 66 (5), 645-651.
Barnes, T.C., Anderson, M.E., & Moots, R.J. (2011). The many faces of interleukin-6: The role of IL-6 in inflammation, vasculopathy, and fibrosis in systemic sclerosis. International Journal of Rheumatology, 2011.
Serebrennikova, S., Seminskу, I., Semenov, N., & Guzovskaya, E. (2012). Interleykin-1, interleykin-10 v regulyatsii vospalitelnogo protsessa [Interleukin-1, interleukin-10 in regulation of inflammatory process]. Sibirskiy meditsinskiy zhurnal – Siberian Medical Journal, 8, 5-8 [in Russian].
Kulias, S.M. (2013). Suchasnyi pohliad na osoblyvosti spetsyfichnoi diahnostyky, likuvannia ta profilaktyky Laim-boreliozu [Current opinion on peculiarities of specific diagnostics, treatment and prevention of lyme borreliosis]. Biomedical and Biosocial Anthropology, 20, 254-250 [in Ukrainian].
Stanek, G., Wormser, G.P., Gray, J., & Strle, F. (2012). Lyme borreliosis. Lancet, 379, 9814, 461-473.