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Doxycycline-mediate...
Doxycycline-mediated effects on persistent symptoms and systemic cytokine responses post-neuroborreliosis: a randomized, prospective, cross-over study
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- Sjöwall, Johanna (author)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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- Ledel, Anna (author)
- Linköpings universitet,Hälsa och samhälle,Hälsouniversitetet
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- Ernerudh, Jan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Klinisk immunologi,Hälsouniversitetet,Klinisk immunologi och transfusionsmedicin
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- Ekerfelt, Christina (author)
- Linköpings universitet,Klinisk immunologi,Hälsouniversitetet
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- Forsberg, Pia (author)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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(creator_code:org_t)
- 2012-08-10
- 2012
- English.
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In: BMC Infectious Diseases. - : BioMed Central Ltd.. - 1471-2334. ; 12:186, s. 1-12
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https://liu.diva-por... (primary) (Raw object)
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https://bmcinfectdis...
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Abstract
Subject headings
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- BACKGROUND:Persistent symptoms after treatment of neuroborreliosis (NB) are well-documented, although the causative mechanisms are mainly unknown. The effect of repeated antibiotic treatment has not been studied in detail. The aim of this study was to determine whether: (1) persistent symptoms improve with doxycycline treatment; (2) doxycycline has an influence on systemic cytokine responses, and; (3) improvement of symptoms could be due to doxycycline-mediated immunomodulation.METHODS/DESIGN:15 NB patients with persistent symptoms ≥6 months post-treatment were double-blindly randomized to receive 200 mg of doxycycline or a placebo for three weeks. After a six-week wash-out period, a cross-over with a three-week course of a placebo or doxycycline was conducted. The primary outcome measures were improvement of persistent symptoms assessed by neurological examinations, a symptom severity score and estimation of the quality of life. The secondary outcome measure was changes in systemic cytokine responses.RESULTS:All 15 patients finished the study. No doxycycline-mediated improvement of post-treatment symptoms or quality of life was observed. Nor could any doxycycline-mediated changes in systemic cytokine responses be detected. The study was completed without any serious adverse events.DISCUSSION:No doxycycline-mediated improvement of post-treatment symptoms or quality of life was observed. Nor could any doxycycline-mediated changes in systemic cytokine responses be detected. The study was completed without any serious adverse events. To conclude, in this pilot study, doxycycline-treatment did not lead to any improvement of either the persistent symptoms or quality of life in post-NB patients. Accordingly, doxycycline does not seem to be the optimal treatment of diverse persistent symptoms post-NB. However, the results need to be confirmed in larger studies.
Keyword
- Neuroborreliosis; Post-treatment; Symptoms; Doxycycline; Immunomodulation; Randomized; Cytokines; Cross-over
Publication and Content Type
- ref (subject category)
- art (subject category)
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