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Decreased Th1-Type ...
Decreased Th1-Type Inflammatory Cytokine Expression in the Skin Is Associated with Persisting Symptoms after Treatment of Erythema Migrans
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- Sjöwall, Johanna (author)
- Linköpings universitet,Hälsouniversitetet,Infektionsmedicin
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- Fryland, Linda (author)
- Linköpings universitet,Hälsouniversitetet,Klinisk immunologi
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- Nordberg, Marika (author)
- Linköpings universitet,Infektionsmedicin,Hälsouniversitetet
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- Sjögren, Florence (author)
- Linköpings universitet,Dermatologi och venerologi,Hälsouniversitetet
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- Garpmo, Ulf (author)
- Kalmar Hospital
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- Jansson, Christian (author)
- Aland Borrelia Grp
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- Carlsson, Sten-Anders (author)
- Aland Borrelia Grp
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- Bergström, Sven (author)
- Umeå universitet,Institutionen för molekylärbiologi (Medicinska fakulteten),Umea University
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- Ernerudh, Jan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Klinisk immunologi,Hälsouniversitetet,Klinisk immunologi och transfusionsmedicin
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- Nyman, Dag (author)
- Aland Borrelia Grp
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- Forsberg, Pia (author)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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- Ekerfelt, Christina (author)
- Linköpings universitet,Hälsouniversitetet,Klinisk immunologi
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(creator_code:org_t)
- 2011-03-31
- 2011
- English.
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3, s. 0018220-
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Abstract
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- Background: Despite the good prognosis of erythema migrans (EM), some patients have persisting symptoms of various character and duration post-treatment. Several factors may affect the clinical outcome of EM, e. g. the early interaction between Borrelia (B.) burgdorferi and the host immune response, the B. burgdorferi genotype, antibiotic treatment as well as other clinical circumstances. Our study was designed to determine whether early cytokine expression in the skin and in peripheral blood in patients with EM is associated with the clinical outcome. Methods: A prospective follow-up study of 109 patients with EM was conducted at the A land Islands, Finland. Symptoms were evaluated at 3, 6, 12 and 24 months post-treatment. Skin biopsies from the EM and healthy skin were immunohistochemically analysed for expression of interleukin (IL)-4, IL-10, IL-12p70 and interferon (IFN)-gamma, as well as for B. burgdorferi DNA. Blood samples were analysed for B. burgdorferi antibodies, allergic predisposition and levels of systemic cytokines. Findings: None of the patients developed late manifestations of Lyme borreliosis. However, at the 6-month follow-up, 7 of 88 patients reported persisting symptoms of diverse character. Compared to asymptomatic patients, these 7 patients showed decreased expression of the Th1-associated cytokine IFN-gamma in the EM biopsies (p = 0.003). B. afzelii DNA was found in 48%, B. garinii in 15% and B. burgdorferi sensu stricto in 1% of the EM biopsies, and species distribution was the same in patients with and without post-treatment symptoms. The two groups did not differ regarding baseline patient characteristics, B. burgdorferi antibodies, allergic predisposition or systemic cytokine levels. Conclusion: Patients with persisting symptoms following an EM show a decreased Th1-type inflammatory response in infected skin early during the infection, which might reflect a dysregulation of the early immune response. This finding supports the importance of an early, local Th1-type response for optimal resolution of LB.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Keyword
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Sjöwall, Johanna
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Fryland, Linda
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Nordberg, Marika
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Sjögren, Florenc ...
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Garpmo, Ulf
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Jansson, Christi ...
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show more...
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Carlsson, Sten-A ...
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Bergström, Sven
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Ernerudh, Jan
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Nyman, Dag
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Forsberg, Pia
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Ekerfelt, Christ ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Microbiology in ...
- Articles in the publication
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PLOS ONE
- By the university
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Linköping University
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Umeå University