Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease.
Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease.
复制标题
莱姆病早期到晚期表现中 C 反应蛋白和血清淀粉样蛋白 A 的表达。
DOI：
10.1093/cid/ciw599
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Alaedini,Armin
中科院分区：
文献类型：
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作者：
Uhde,Melanie;Ajamian,Mary;Li,Xueting;Wormser,GaryP;Marques,Adriana;Alaedini,Armin
研究背景莱姆病的病原体伯氏疏螺旋体（Borrelia burgdorferi）的感染可引发宿主免疫反应，影响临床预后，是具有诊断价值的生物标志物的来源。虽然对B.虽然莱姆病的先天性急性期反应已经被广泛表征，但关于莱姆病中先天性急性期反应的发展的信息却少得多。本研究的目的是评估C-反应蛋白（CRP）和血清淀粉样蛋白A（SAA）的表达，这是原型急性时相反应蛋白，在与莱姆病相关的不同表现的背景下，结果莱姆病早期局限性和早期播散性患者血清CRP和SAA水平明显升高，而活动性感染晚期患者血清CRP和SAA水平无明显变化。CRP的水平，但不SAA，也被发现显着增加，在患者与难治性莱姆病关节炎和那些治疗后莱姆病syndrome.ConclusionsThese研究结果表明，循环CRP和SAA水平最高时，螺旋体的浓度是最大的皮肤和/或血液中，并在随后的阶段的感染后，生物体的传播到皮外部位的水平下降。这些数据还表明，难治性莱姆病关节炎和治疗后莱姆病综合征与CRP反应升高有关，CRP反应由与活动性感染不同的炎症机制驱动。
BackgroundInfection withBorrelia burgdorferi, the causative agent of Lyme disease, triggers host immune responses that affect the clinical outcome and are a source of biomarkers with diagnostic utility. Although adaptive immunity toB. burgdorferihas been extensively characterized, considerably less information is available about the development of innate acute-phase responses in Lyme disease. Our aim in this study was to evaluate the expression of C-reactive protein (CRP) and serum amyloid A (SAA), the prototype acute-phase response proteins, in the context of the varying manifestations associated with Lyme borreliosis.MethodsCirculating concentrations of CRP and SAA in patients with a range of early to late objective manifestations of Lyme disease and in individuals with post-treatment Lyme disease syndrome were compared with those in healthy control groups.ResultsCRP and SAA levels were significantly elevated in early localized and early disseminated Lyme disease but not in the later stages of active infection. Levels of CRP, but not SAA, were also found to be significantly increased in patients with antibiotic-refractory Lyme arthritis and in those with post-treatment Lyme disease syndrome.ConclusionsThese findings indicate that circulating CRP and SAA levels are highest when the concentration of spirochetes is greatest in skin and/or blood and that levels decline after the dissemination of the organism to extracutaneous sites in subsequent stages of infection. The data also suggest that antibiotic-refractory Lyme arthritis and post-treatment Lyme disease syndrome are associated with elevated CRP responses that are driven by inflammatory mechanisms distinct from those in active infection.