DETECTION OF MARKERS OF SOME TICK-BORNE INFECTIONS IN PATIENTS WITH LOCALIZED SCLERODERMA IN THE PRACTICE OF A FAMILY PHYSICIAN
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14300Keywords:
localized scleroderma, Lyme borreliosis, bartonellosis, specific antibodies of classes M and G, ELISA, immunoblot, multiplex indirect immunofluorescence, BIOCHIP technologyAbstract
SUMMARY. The aim – to determine the frequency of detection of serological markers of Lyme borreliosis and bartonellosis in patients with localized scleroderma.
Material and Мethods. The study included 68 patients aged 19 to 60 years with localized scleroderma who were treated on an outpatient basis in 2019–2022 at the Ternopil Regional Clinical Dermatology and Venereological Dispensary of the Ternopil Regional Council and at the Ternopil District Primary Health Care Center of the Velyka Berezovytsia Rural Council. There were 12 men (17.6 %) and 56 women (82.4 %). The diagnosis of localized scleroderma was established on the basis of the clinical manifestations of the disease and was formulated according to the ICD-10 classification, code L94.0. To determine the possible infection of patients with localized scleroderma with Lyme borreliosis and bartonellosis pathogens, a unified questionnaire developed by scientists of I. Horbachevsky Ternopil National Medical University and the Pope John Paul II State Higher School (Biala Podlaska, Poland) was used. To detect specific IgM and/or IgG to B. burgdorferi s. l. (causative agents of Lyme borreliosis) in blood serum, a two-step method (ELISA and immunoblot) was used using test systems from Euroimmun AG (Germany). The results were analyzed according to the recommendations of the test system manufacturer. Specific class G antibodies to Bartonella henselae and B. quintana (causative agents of bartonellosis) were determined in patients' sera by multiplex indirect immunofluorescence using the test system "Mosaic for Bartonella henselae / Bartonella quintana (IgG)", Euroimmun AG (Germany), using BIOCHIP technology, which contained fluorescein-labeled antigens of these bartonella species. The results were evaluated in the field of view of a fluorescence microscope (Olympus IX70, ok ×10, ob ×20; 40) by the bright green glow of the fluorescein-labeled antigen-antibody immune complex to B. quintana – fluorescence was from fine to coarse-grained.
Results. The use of a two-stage serological study – ELISA and immunoblot - allowed to detect antibodies of classes M and/or G to B. burgdorferi s. l. in 24 (35.5 %) patients with localized scleroderma, which permit for 22 (32.4 %) patients to establish the final diagnosis of localized scleroderma combined with LB. By multiplexed indirect immunofluorescence using BIOCHIP technology, serum G class antibodies to B. henselae were found in 16.2 % of patients with localized scleroderma. In 13.2 % of the examined patients, localized scleroderma combined with LB and bartonellosis caused by B. henselae was diagnosed.
Conclusion. Family physicians should examine patients with localized scleroderma with the presence of prolonged fever, enlarged lymph nodes, myalgias, arthralgias, fatigue/general weakness, impaired concentration and anamnesis of tick bites or even stay in an area endemic for Lyme disease for the possibility of combined dermatosis with Lyme borreliosis and bartonellosis caused by B. henselae.
References
Flynn, C.D., Sandomierski, M., Kim, K., Lewis, J., Lloyd, V., & Ignaszak, A. (2023). Electrochemical Detection of Borrelia burgdorferi Using a Biomimetic Flow Cell System. ACS Measurement Science Au. DOI: https://doi.org/10.1021/acsmeasuresciau.3c00004
Dong, Y., Zhou, G., Cao, W., Xu, X., Zhang, Y., Ji, Z., … & Bao, F. (2022). Global seroprevalence and sociodemographic characteristics of Borrelia burgdorferi sensu lato in human populations: a systematic review and meta-analysis. BMJ Global Health, 7(6), e007744. DOI: https://doi.org/10.1136/bmjgh-2021-007744
Marques, A.R., Strle, F., & Wormser, G.P. (2021). Comparison of Lyme Disease in the United States and Europe. Emerging Infectious Diseases, 27(8), 2017-2024. DOI: https://doi.org/10.3201/eid2708.204763
Nebogatkin, I.V., & Shulgan, A.M. (2020). Epidemiolohichni y epizootychni osoblyvosti khvoroby Layma u 2019 rotsi v Ukrayini [Epidemiological and epizootic features of Lyme disease in 2019 in Ukraine]. Aktualna infektolohiya – Actual infectology, 8(5-6), 44-48 [in Ukrainian]. DOI: https://doi.org/10.22141/2312-413x.8.5-6.2020.217959
Zadorozhna, V.I., Rudenko, A.O., & Klyus, V.Y. (2017). Laym-borelioz – osoblyvo nebezpechna infektsiya. Zahrozy ta ryzyky [Lyme Borreliosis - a particularly dangerous infection. Threats and Risk]. Veterynarna medytsyna – Veterinary Medicine, (103), 30-32 [in Ukrainian].
Baquer, F., Jaulhac, B., Barthel, C., Paz, M., Wolfgramm, J., Müller, A., Boulanger, N., & Grillon, A. (2023). Skin microbiota secretomes modulate cutaneous innate immunity against Borrelia burgdorferi s.s. Scientific Reports, 13(1). DOI: https://doi.org/10.1038/s41598-023-43566-0
Trevisan, G., & Cinco, M. (2022). Borrelia Lyme Group. Journal of Dermatology Research Reviews & Reports, 1-12. DOI: 10.47363/jdmrs/2022(3)142. DOI: https://doi.org/10.47363/JDMRS/2022(3)142
Trevisan, G., Cinco, M., Trevisini, S., di Meo, N., Chersi, K., Ruscio, M., Forgione, P., & Bonin, S. (2021). Borreliae Part 1: Borrelia Lyme Group and Echidna-Reptile Group. Biology, 10(10), 1036. DOI: https://doi.org/10.3390/biology10101036
Andreychin, M.A., Kopcha, V.S., & Shkilna, M.I. (2019). Laym-borelioz. Diahnostychni kryteriyi, likuvannya i profilaktyka : metod. rekomendatsiyi [Lyme borreliosis. Diagnostic criteria, treatment and prevention: methodological recommendations]. Ternopil: TSMU [in Ukrainian].
Vasudevan, B., & Chatterjee, M. (2013). Lyme borreliosis and skin. Indian Journal of Dermatology, 58(3), 167. DOI: https://doi.org/10.4103/0019-5154.110822
Melenko, S.R., Melnyk, K.V., & Senyshyn, Kh.V. (2023). Lime Boreliosis: Modern Problem of Infectology. Colloquium-journal, 7(166), 8-13.
Guérin, M., Shawky, M., Zedan, A., Octave, S., Avalle, B., Maffucci, I., & Padiolleau-Lefèvre, S. (2023). Lyme borreliosis diagnosis: state of the art of improvements and innovations. BMC Microbiology, 23(1). DOI: https://doi.org/10.1186/s12866-023-02935-5
Hatchette, T., & Lindsay, R. (2020). Modified two-tiered testing algorithm for Lyme disease serology: the Canadian context. Canada Communicable Disease Report, 46(5), 125-131. DOI: https://doi.org/10.14745/ccdr.v46i05a05
Eldin, C., Raffetin, A., Bouiller, K., Hansmann, Y., Roblot, F., Raoult, D., & Parola, P. (2019). Review of European and American guidelines for the diagnosis of Lyme borreliosis. Médecine et Maladies Infectieuses, 49(2), 121-132. DOI: https://doi.org/10.1016/j.medmal.2018.11.011
Luan, Y., Gou, J., Zhong, D., Ma, L., Yin, C., Shu, M., Liu, G., & Lin, Q. (2023). The Tick-Borne Pathogens: An Overview of China’s Situation. Acta Parasitologica. DOI: https://doi.org/10.1007/s11686-023-00658-1
Sprong, H., Azagi, T., Hoornstra, D., Nijhof, A.M., Knorr, S., Baarsma, M.E., & Hovius, J.W. (2018). Control of Lyme borreliosis and other Ixodes ricinus-borne diseases. Parasites & Vectors, 11(1). DOI: https://doi.org/10.1186/s13071-018-2744-5
Tokarz, R., Tagliafierro, T., Cucura, D.M., Rochlin, I., Sameroff, S., & Lipkin, W.I. (2017). Detection of Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan Virus in Ticks by a Multiplex Real-Time Reverse Transcription-PCR Assay. mSphere, 2(2). DOI: https://doi.org/10.1128/mSphere.00151-17
Berghoff, W. (2012). Chronic Lyme Disease and Co-infections: Differential Diagnosis. The Open Neurology Journal, 6(1), 158-178. DOI: 10.2174/1874205x01206010158. DOI: https://doi.org/10.2174/1874205X01206010158
Petruk, A.M., Ivakhiv, O.L., Kachor, V.O., Zhulkevych, I.V., Korda, M.M., & Klishch, I.M. (2022). Markery Laym-boreliozu, bartonelozu i lyambliozu u patsiyentiv iz kropyvyankoyu [Markers of Lyme borreliosis, bartonellosis and giardiasis in patients with urticarial]. Infektsiyni khvoroby – Infectious diseases, 4, 26-31 [in Ukrainian].
Lins, K.d.A., Drummond, M.R., & Velho, P.E.N.F. (2019). Cutaneous manifestations of bartonellosis. Anais Brasileiros de Dermatologia, 94(5), 594-602. DOI: https://doi.org/10.1016/j.abd.2019.09.024
Kim, M., Choi, M., Seong, G., Park, M., Park, M., Hong, S., & Park, B. (2020). Rapidly progressing generalized morphea with high lyme disease titer. Indian Journal of Dermatology, 65(5), 432. DOI: https://doi.org/10.4103/ijd.IJD_279_18
Șandru, F., Popa, A., Petca, A., Miulescu, R., Constantin, M., Petca, R., Constantin, T., & Dumitrașcu, M. (2020). Etiologic role of Borrelia burgdorferi in morphea: A case report. Experimental and Therapeutic Medicine. DOI: https://doi.org/10.3892/etm.2020.8815
Zinchuk, O.M., & Kalyuzhna, L.D. (2016). Urazhennya shkiry u khvorykh na Laym-borelioz piznioho periodu [Skin lesions in patients with late-onset Lyme borreliosis]. Dermatolohiya, kosmetolohiya, seksopatolohiya – Dermatology, cosmetology, sexopathology, 1-2, 10-14 [in Ukrainian].
Wagemakers, A., Jahfari, S., de Wever, B., Spanjaard, L., Starink, M.V., de Vries, H.J.C., Sprong, H., & Hovius, J.W. (2017). Borrelia miyamotoi in vectors and hosts in The Netherlands. Ticks and Tick-borne Diseases, 8(3), 370-374. DOI: https://doi.org/10.1016/j.ttbdis.2016.12.012
Strobino, B., Steinhagen, K., Meyer, W., Scheper, T., Saschenbrecker, S., Schlumberger, W., Stöcker, W., Gaito, A., & Fallon, B. (2018). A Community Study of Borrelia burgdorferi Antibodies among Individuals with Prior Lyme Disease in Endemic Areas. Healthcare, 6(2), 69. DOI: https://doi.org/10.3390/healthcare6020069
Santos, M., Ribeiro-Rodrigues, R., Talhari, C., Ferreira, L.C.L., Zelger, B., & Talhari, S. (2011). Presence of Borrelia burgdorferi“Sensu Lato” in patients with morphea from the Amazonic region in Brazil. International Journal of Dermatology, 50(11), 1373-1378. DOI: https://doi.org/10.1111/j.1365-4632.2011.05081.x
Aydin, N., Bülbül, R., Telli, M., & Gültekin, B. (2014). Seroprevalence of Bartonella henselae and Bartonella quintana in Blood Donors in Aydin Province, Turkey. Mikrobiyoloji Bulteni, 48(3), 477-483. DOI: https://doi.org/10.5578/mb.7598
Łysakowska, M.E., Brzezińska, O., Szybka, M., Konieczka, M., Moskwa, S., Brauncajs, M., … & Grzegorczyk, J. (2019). The seroprevalence of Bartonella spp. in the blood of patients with musculoskeletal complaints and blood donors, Poland: a pilot study. Clinical Rheumatology, 38(10), 2691-2698. DOI: https://doi.org/10.1007/s10067-019-04591-5
