THE SPIROCHETAL ETIOLOGY OF LYME-DISEASE
THE SPIROCHETAL ETIOLOGY OF LYME-DISEASE
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DOI：
10.1056/nejm198303313081301
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发表时间：
1983-01-01
影响因子：
158.5
通讯作者：
MALAWISTA, SE
中科院分区：
文献类型：
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作者：
STEERE, AC;GRODZICKI, RL;MALAWISTA, SE
从血液，皮肤病变（红斑术语[ECM]）或56例莱姆病患者中的3例中发现了新认识的螺旋体，在康涅狄格州[美国]的110名若虫或成人ixodes dammini tick中的31例中有3例CSF。这些分离株和来自I. Dammini的原始物具有相同的形态和免疫学特征。在患者中，特定的IgM抗体滴度通常在疾病发作后达到3-6周的峰值。特定的IgG抗体滴度升高缓慢，通常是在存在关节炎时最高的几个月。在40例仅患有早期疾病的患者中（仅ECM），在ECM期和康复之间，有90％的IgM滴度升高（.gtoreq。1：128）。在95例后期表现（神经系统，心脏或关节的参与）的患者中，有94％的IgG滴度升高（.gtoreq。1：128）。 80名对照受试者中没有一个具有升高的IgG滴度。只有3例感染性单核细胞增多症患者的IgM滴度升高。因此，Dammini螺旋体是莱姆病的病因。
A newly recognized spirochete was recovered from the blood, skin lesions (erythema chronicum migrans [ECM]) or CSF of 3 of 56 patients with Lyme disease and from 21 of 110 nymphal or adult Ixodes dammini ticks in Connecticut [USA]. These isolates and the original one from I. dammini had the same morphologic and immunologic features. In patients, specific IgM antibody titers usually reached a peak 3-6 wk after the onset of disease; specific IgG antibody titers rose slowly and were generally highest months later when arthritis was present. Among 40 patients who had early disease only (ECM alone), 90% had an elevated IgM titer (.gtoreq. 1:128) between the ECM phase and convalescence. Among 95 patients with later manifestations (involvement of the nervous system, heart or joints), 94% had elevated titers of IgG (.gtoreq. 1:128). None of 80 control subjects had elevated IgG titers; only 3 control patients with infectious mononucleosis had elevated IgM titers. Thus, the I. dammini spirochete is the causative agent of Lyme disease.