TITLE: Bone and joint manifestations of systemic infectious diseases.
AUTHORS: Kosinski M; Rodriguez-Diaz A
AUTHOR AFFILIATION: New York College of Podiatric Medicine, New York, USA. SOURCE: Clin Podiatr Med Surg 1998 Oct;15(4):673-86, vi
CITATION IDS: PMID: 9917985 UI: 99116510
ABSTRACT: Bone and joint infections can occur as the consequence of a wide variety of systemic diseases. Disseminated fungal and mycobacterial infections, hepatitis, syphilis, gonorrhea, Lyme disease, and AIDS can all have osteoarticular manifestations. A thorough knowledge of the wide range of potential pathogens is key to establishing a correct diagnosis and instituting appropriate treatment.
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL LANGUAGES: Eng
REPOST:
Bb in bone marrow with Lyme and syphilis
Source: Journal of Spirochetal and Tick-borne Diseases-Vol. 4- Fall/Winter 1997-pgs. 58-60
title: Bone Marrow as a Source for Borrelia burgdorferi DNA
authors: Lesley Fein, MD, MPh and Richard Tilton, PhD
abstract: The diagnosis of persistent Lyme disease has depended on the detection of serum antibody to Borrelia burgdorferi. Patients may lose their immune response over time or it may be abrogated by antimicrobial therapy. These case reports describe patients with chronic Lyme disease and a reactive bone marrow polymerase chain reaction (PCR). After appropriate and aggressive treatment, specific DNA may persist in sequestered sites such as bone marrow.
source- Karen's book:
1985
"Researchers publish the first proof of maternal-fetal transmission of Bb. The baby died shortly after birth and Bb was demonstrated in the baby's spleen, kidney, and bone marrow."
Source: Schlesinger et al. (1985)
Title: Bone marrow-derived macrophage lines and immortalized cloned macrophage and dendritic cells support priming of Borrelia burgdorferi--specific T cell responses in vitro and/or in vivo.
Authors: Altenschmidt U, Ricciardi-Castagnoli P, Modolell M, Otto H, Wiesmuller KH, Jung G, Simon MM
Source: Immunol Lett 1996 Apr;50(1-2):41-9
Organization: Max-Planck-Institut fur Immunobiology, Freiburg, Germany.
Abstract:
In vitro propagated bone marrow-derived macrophage populations (BMMO) as well as cloned immortalized macrophage (MT2/1) and dendritic (D2SC/1) cell lines were analyzed for their capacity to promote activation and/or proliferation of naive T cells to Borrelia burgdorferi antigens in vitro and in vivo. All three cell types constitutively express high levels of MHC class I structures as well as the co-stimulatory molecules B7/BB1 and heat-stable antigen (HSA); MHC class II molecules (I-A) are upregulated following incubation with either intact spirochetes or the purified lipoprotein OspA (Lip-OspA) but not with its delipidated from (MDP-OspA). Only BMMO were able to induce proliferation of naive T cells or T cells derived from infected mice to intact spirochetes in vitro. However, all three accessory populations could support primary and secondary T cell responses to Lip-OspA but not, or only marginally, to MDP-OspA under similar conditions. The number of accessory cells required for optimal stimulation of naive or pre-sensitized T cells was approximately 3 x lower for D2SC 1 than for BMMO or MT2/1. In addition, BMMO pre-pulsed with Lip-OspA were able to prime T cells in vivo, indicating a crucial role for the lipid moiety in antigen presentation. From two truncated lipopeptides of Lip-OspA containing either 20 or 6 aminoterminal residues, only Lip-OspApep20 but not Lip-OspApep6 induced significant proliferation in naive for pre-sensitized T cells in vitro, suggesting that T cells mainly respond to the protein rather than the lipid moiety of OspA. Thus, the data demonstrate that BMMO, MT2/1 and D2SC/1 have differential capacities to prime spirochete-reactive T cells and to support their growth in vitro, suggesting that optimal activation and propagation of T cells also depends on the quality of the antigen.
Keywords:
Amino Acid Sequence, Animal, Antigens, Surface, IMMUNOLOGY, Bacterial Outer Membrane Proteins, IMMUNOLOGY, Bone Marrow, CYTOLOGY, Borrelia burgdorferi, IMMUNOLOGY, Cell Line, Clone Cells, Female, Histocompatibility Antigens Class II, IMMUNOLOGY, Immunization, Macrophages, CYTOLOGY, IMMUNOLOGY, Mice, Mice, Inbred BALB C, Mice, Inbred C57BL, Molecular Sequence Data, Support, Non-U.S. Gov't, T-Lymphocytes, IMMUNOLOGY
Language: Eng
Unique ID: 96385728
Title: Dual role of interleukin-10 in murine Lyme disease: regulation of arthritis severity and host defense.
Authors: Brown JP, Zachary JF, Teuscher C, Weis JJ, Wooten RM
Source: Infect Immun 1999 Oct;67(10):5142-50
Organization: Division of Cell Biology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
Abstract:
In the murine model of Lyme disease, C3H/He mice exhibit severe arthritis while C57BL/6N mice exhibit mild lesions when infected with Borrelia burgdorferi. Joint tissues from these two strains of mice harbor similar concentrations of B. burgdorferi, suggesting that the difference in disease severity reflects differences in the magnitude of the inflammatory response to B. burgdorferi lipoproteins. Stimulation of bone marrow macrophages from C3H/HeN mice with the B. burgdorferi lipoprotein OspA resulted in higher-level production of the inflammatory mediators tumor necrosis factor alpha, nitric oxide, and interleukin-6 (IL-6) than that of macrophages from C57BL/6N mice. In contrast, macrophages from C57BL/6N mice consistently produced larger amounts of the anti-inflammatory cytokine IL-10 than did C3H/HeN macrophages. Addition of recombinant IL-10 suppressed the production of inflammatory mediators by macrophages from both strains. IL-10 was found to modulate B. burgdorferi-induced inflammation in vivo, since C57BL/6J mice deficient in IL-10 (IL-10-/-) developed more severe arthritis than wild-type C57BL/6J mice. The increase in arthritis severity was associated with a 10-fold decrease in the number of B. burgdorferi organisms present in ankle tissues from IL-10-/- mice. These findings suggest that in C57BL/6 mice, IL-10-dependent regulation of arthritis severity occurs at the expense of effective control of bacterial numbers.
Keywords:
Animal, Antibodies, Bacterial, BIOSYNTHESIS, Antigens, Surface, PHARMACOLOGY, Bacterial Outer Membrane Proteins, PHARMACOLOGY, Borrelia burgdorferi, ISOLATION & PURIF, Cells, Cultured, Female, Interleukin-10, PHYSIOLOGY, Lyme Disease, IMMUNOLOGY, MICROBIOLOGY, Macrophages, IMMUNOLOGY, Mice, Mice, Inbred C3H, Mice, Inbred C57BL, Support, Non-U.S. Gov't, Support, U.S. Gov't, P.H.S.
Language: Eng
Unique ID: 99426806
Conference Abstract
Title: Human Granulocytic Ehrlichiosis: Clinical and Biological Features of an Emerging Infection
Authors: Goodman JL
Conference: 10th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, National Institutes of Health, Bethesda, MD April 28-30, 1997
Presenter: Jesse L. Goodman, M.D.
Infectious Diseases, Dept. of Medicine
University of Minnesota, School of Medicine
Abstract:
Human Granulocytic Ehrlichiosis (HGE) is an acute febrile illness usually accompanied by thrombocytopenia, leukopenia and elevations in serum hepatic transaminases. The disease was first reported in patients in Minnesota and Wisconsin by Bakken and colleagues who noted intracellular inclusions in granulocytes suggestive of an ehrlichial infection. Chen and colleagues utilized PCR amplification of 16S rDNA sequences from the blood to show that the causative organism was likely an ehrlichia closely related to the agents of equine and ruminant ehrlichiosis, E. equi and E. phagocytophila. Our laboratory then reported isolation of the etiologic agent from patients with characteristic clinical findings through utilization of the HL60 promyelocytic leukemia cell line. Isolates from 3 patients had 16S sequences which differed at only one nucleotide from a strain of E. equi we sequenced. We also developed sensitive and specific PCR primers for improved diagnosis and have since noted that approximately 50% of culture positive patients, while also PCR positive, have blood smears which do not show characteristic inclusions.
Isolation and continuous cultivation of the agent has provided the basis for further studies aimed at better understanding the pathogenesis and cell biology of infection and at improved treatment. Detailed antibiotic susceptibility studies revealed that, while sensitive to tetracyclines, HGE is resistant to the other antibiotics commonly used to treat LD such as B-lactams and macrolides. Agents with promising in vitro activity against HGE include some of the quinolones, in particular the developmental agent trovafloxacin, and the rifamycins. Since coinfections with Lyme disease are not rare, these findings emphasize that tetracyclines are currently the preferred treatment for both early LD and HGE.
We have recently documented that the HGE agent can also infect CD34 positive bone marrow progenitor cells, including CD14 positive monocytic cells. This finding suggests that the bone marrow may be an important target of infection in patients and that such infection is likely to play a role in the cytopenias observed. The agent's interaction with monocytes is also likely to be important in early events in infection and in the host's response. The development of a culture system utilizing normal primary human cells provides an alternative to the use of HL60 or other transformed cell lines that will be important in better understanding the agents interactions with its natural target cells. In addition, antigen prepared from the human isolates in HL60 cells has led to the development of improved and reproducible serologic assays which have been useful for diagnostic and epidemiologic purposes.
Unique ID: 97LDF015
Title: Presence and distribution of Borrelia burgdorferi sensu lato species in internal organs and skin of naturally infected symptomatic and asymptomatic dogs, as detected by polymerase chain reaction.
Authors: Hovius KE, Stark LA, Bleumink-Pluym NM, van de Pol I, Verbeek-de Kruif N, Rijpkema SG, Schouls LM, Houwers DJ
Source: Vet Q 1999 Apr;21(2):54-8
Organization: Companion Animal Hospital 't Heike, Veldhoven, The Netherlands.
kehovius@iaehv.nl
Abstract:
Tissues from Dutch family dogs symptomatic for borreliosis according to established criteria and from infected but asymptomatic dogs were tested for Borrelia burgdorferi sensu lato DNA using a polymerase chain reaction. Subsequently, B. burgdorferi sensu stricto, B. garinii, B. afzelii, and B. valaisiana were identified by hybridization. Symptomatic dogs showed a higher prevalence of Borrelia in liver samples (9 of 15) than asymptomatic dogs (9 of 43) p = 0.0049. Overall, B. garinii was the most prevalent species and occurred together with up to three other species in on liver sample. B. burgdorferi sensu stricto however, was predominantly detected in samples of synovial membranes, skin, cerebrospinal fluid, bladder, heart, and bone marrow. Nine out of 10 symptomatic dogs with a very high antibody titre were positive for Borrelia DNA by PCR in one or more of these tissues. We conclude that dissemination in naturally infected European dogs occurs and that the two most prevalent species, B. burgdorferi sensu stricto and B. garinii, differ in their tropism.
Keywords:
Animal, Borrelia burgdorferi, ISOLATION & PURIF, PATHOGENICITY, Dog Diseases, MICROBIOLOGY, Dogs, Female, Liver, MICROBIOLOGY, Lyme Disease, MICROBIOLOGY, VETERINARY, Male, Polymerase Chain Reaction, Skin, MICROBIOLOGY, Tissue Distribution
Language: Eng
Unique ID: 99254317
Title: Borrelia burgdorferi outer surface lipoproteins OspA and OspB possess B-cell mitogenic and cytokine-stimulatory properties.
Authors: Ma Y, Weis JJ
Source: Infect Immun 1993 Sep;61(9):3843-53
Organization: Department of Pathology, University of Utah School of Medicine, Salt Lake City 84132.
Abstract:
Sonicated Borrelia burgdorferi was previously reported to possess both B-cell mitogenic and interleukin-6 (IL-6) stimulatory activities. In this report, two outer surface lipoproteins, OspA and OspB, were purified from B. burgdorferi and assessed for the presence of these functions. OspA was purified from two strains, an OspB-deficient variant of HB19 and N40, while OspB was purified from the N40 strain. All lipoprotein preparations were free of endotoxin contamination, and polymyxin B failed to inhibit responses, indicating that media contamination was not contributing to biological assays. All three preparations were able to stimulate proliferation of mononuclear cells from naive C3H/HeJ and BALB/c mice. Depletion experiments indicated that the responding cells were B lymphocytes and not T lymphocytes. Purified OspA and OspB stimulated immunoglobulin M production by splenocyte cultures from naive mice, a property also previously attributed to sonicated B. burgdorferi. OspA and OspB also stimulated the production of IL-6 and tumor necrosis factor alpha by bone marrow-derived macrophages from BALB/c and C3H/HeJ mice. Cytokine production was enhanced by the presence of gamma interferon in the cultures, indicating that the magnitude of responses to these lipoproteins may be modulated by cytokines in the microenvironment of infected tissues. Human endothelial cells produced IL-6 when incubated with OspA and OspB, indicating that non-hematopoietic lineage cells can respond to the lipoproteins. Purified OspA and OspB had approximately equal activity, with responses detected in the range of 10 ng of lipoprotein per ml to 1 microgram of lipoprotein per ml. Comparison with published dose responses for lipoproteins purified from Escherichia coli indicates that OspA and OspB purified from B. burgdorferi are much more potent. The high potency of the B. burgdorferi lipoproteins and the ability of the spirochete to invade tissues and persist argue that they could be important in the localized events contributing to the pathology of Lyme disease.
Keywords:
Animal, Antigens, Surface, ISOLATION & PURIF, PHARMACOLOGY, B-Lymphocytes, IMMUNOLOGY, Bacterial Outer Membrane Proteins, ISOLATION & PURIF, PHARMACOLOGY, Borrelia burgdorferi, CHEMISTRY, Cells, Cultured, Cytokines, BIOSYNTHESIS, Human, Interleukin-6, BIOSYNTHESIS, Lymphocyte Transformation, DRUG EFFECTS, Mice, Mice, Inbred BALB C, Mice, Inbred C3H, Mitogens, PHARMACOLOGY, Support, Non-U.S. Gov't, Support, U.S. Gov't, P.H.S., Tumor Necrosis Factor, BIOSYNTHESIS
Language: Eng
Unique ID: 93366445
________________________
Title: [Agranulocytosis caused by infectious-toxic bone marrow damage after Borrelia infection]
Authors: Kamp T, Zink C, Beer C, Kaboth W, Nerl C
Source: Dtsch Med Wochenschr 1995 May 5;120(18):636-40
Organization: I. Medizinische Abteilung, Stadtisches Krankenhaus Munchen-Schwabing.
Abstract:
A 19-year-old girl developed a fever of up to 40 degrees C and, during an episode of high fever, generalized seizures. Physical examination on admission was unremarkable, except for several small lymph nodes. Differential blood count showed a leukopenia (1700/microliters) with 14% stab and 7% segmented neutrophils. After initial clinical improvement she again became feverish and the differential count now showed agranulocytosis with a total white cell count of 1400/microliters. Because of the time of year and the geographic location borreliosis was now considered in the differential diagnosis. The antibody titre against Borrelia was raised to 1:64 (IgM) and 1:256 (IgG). Her condition and the differential blood count rapidly improved on intravenous antibiotic treatment with cefotiam (2 g two times daily) and gentamicin (120 mg two times daily), as well as filgrastim (granulocyte-colony stimulating factor) subcutaneously. Antibiotic treatment was continued after 6 days with oral ampicillin (1 g three times daily) for 3 weeks. Follow-up examination six weeks later found the patient to be symptom-free.
Language: Ger
Unique ID: 95269608
_____________________
source: Bad Blood The Tuskegee Syphilis Experiment by James H.
Jones.
"Secondary syphilis gives way in most cases, even without
treatment, to a period of latency that may last from a few weeks to thirty years. As if by magic, all symptoms of the disease seem to disappear, and
the syphilitic patient does not associate with the disease's earlier
symptoms the occasional skin infections, periodic chest pains, eye
disorders, and vague discomforts that may follow. But the spirochetes do
not vanish once the disease becomes latent. They bore into the bone
marrow, lymph glands, vital organs, and central nervous systems of their victims. In some cases the disease seems to follow a policy of peaceful coexistence, and its hosts are able to enjoy full and long lives. Even so, autopsies in such cases often reveal syphilitic lesions in vital organs as contributing causes of death. For many syphilitic patients, however, the disease remains latent only two or three years. Then the delusion of a
truce is shattered by the appearance of signs and symptoms that denote the tertiary stage.
"It is during late syphilis, as the tertiary stage is also called,
that the disease inflicts the greatest damage. Gummy or rubbery tumors (so-called gummas), the characteristic lesions of late syphilis, appear resulting from the concentration of spirochetes in the body's tissues with destruction of vital structures. These tumors often coalesce on the skin forming large ulcers covered with a crust consisting of several layers of
dried exuded matter. Their assaults on bone structure produce
deterioration that resembles osteomyelitis or bone tuberculosis. The small tumors may be absorbed , leaving slight scarred depressions, or they may
cause wholesale destruction of the bone, such as the horrible mutilation
that occurs when nasal and palate bones are eaten away. The liver may be attacked, here the result is scarring and deformity of the organ that
impede circulation in the intestines.
"The cardiovascular and central nervous systems are frequent and often fatal targets of late syphilis. The tumors may attack the walls of the
heart or the blood vessels. When the aorta is involved, the walls become weakened, scar tissue forms over the lesion, the artery dilates, and the
valves of the heart no longer open and close properly and begin to leak.
The stretching of the vessel walls may produce an aneurysm, a balloonlike
bulge in the aorta. If the bulge bursts, and sooner or later most do, the result is sudden death.
"The results of neurosyphilis are equally devastating. Syphilis is
spread to the brain through the blood vessels, and while the disease can
take several forms, the best known is paresis, a general softening of the
brain that produces progressive paralysis and insanity. Tabes dorsalis, another form of neurosyphilis, produces a stumbling, foot-slapping gait in
its victims due the destruction of nerve cells in the spinal cord.
Syphilis can also attack the optic nerve, causing blindness, or the eighth cranial nerve, inflicting deafness."
Lyme Disease and its Neurologic Complications
Michael F. Finkel, M.D.
..........Conclusion: Lyme disease presents a new set of challenges to physicians. Once again, a spirochetal disease is manifesting itself as a "great imitator" to primary care physicians as well as specialists. The
full impact of the disease is not yet known, as it is presently underrecognized, underreported, and undertreated.....
Chronic Neurologic Manifestations of Lyme Disease
Loggian, Kaplan, Steere
,,,,,,,Discussion.....These chronic neurologic abnormalities began months
to years after the onset of infection, sometimes after long periods of
latency, as in neurosyphilis....The typical response of our patients to antibiotic therapy supports the role of spirochetal infection in the pathogenisis of each of the syndromes described here......The likely reason
for relapse is failure to eradicate the spirochete.......This is
reminiscent of far advanced neurosyphilis.......
This last article is one of many studies that show continuing symptoms are
most likely due to persistence of the spirochete. _________________________________
TITLE: Bone invasion in secondary syphilis: case reports.
AUTHORS: Olle-Goig JE; Barrio JL; Gurgui M; Mildvan D
AUTHOR AFFILIATION: Department of Medicine, Beth Israel Medical Center, New York.
SOURCE: Genitourin Med 1988 Jun;64(3):198-201
CITATION IDS: PMID: 3410468 UI: 88314092
ABSTRACT: The affinity of treponemes for bone tissue is well known, but the incidence of bone infection in the early stages of syphilis is uncertain. Although case reports of early bone invasion are few, reviews of large numbers of patients with early syphilis indicate that the incidence is probably greater than at present believed. Two case reports are presented.MAIN MESH HEADINGS: Bone Diseases/*radiography
Skull/*radiography
Syphilis/*radiography
Tibia/*radiography ADDITIONAL MESH HEADINGS: Adult
Bone Diseases/radionuclide imaging
Case Report
Female
Human
Male
Skull/radionuclide imaging
Syphilis/radionuclide imaging
Tibia/radionuclide imaging PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
TITLE: Osseous manifestations in congenital syphilis: a study of 55 cases. AUTHORS: Sachdev M; Bery K; Chawla S
SOURCE: Clin Radiol 1982 May 3;33(3):319-23
CITATION IDS: PMID: 7075138 UI: 82185343
ABSTRACT: Radiology plays an important role in the early diagnosis of congenital syphilis. Osseous manifestations in 55 cases of congenital syphilis have been analysed and their radiological appearances described. In addition to the common findings of metaphysitis, periostitis and osteitis of the long bones, unusual involvement of the skull, mandible, nasal septum, scapulae and short bones of the hands and feet was observed.MAIN MESH HEADINGS: Bone and Bones/*radiography
Syphilis, Congenital/*radiography ADDITIONAL MESH HEADINGS: Bone Diseases/etiology
Child
Child, Preschool
Female
Human
Infant
Male
Syphilis, Congenital/complications PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES:
Sent from my iPhone
--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)