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Ulber R, Faurie R, Sosnitza P, Fischer L, Stärk E, Harbeck C, Scheper T. Monitoring and control of industrial downstream processing of sugar beet molasses. J Chromatogr A 2000; 882:329-34. [PMID: 10895955 DOI: 10.1016/s0021-9673(00)00312-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In present work the determination of several amino acids during the industrial chromatographic desugarisation of molasses is presented. The use of innovative biosensor systems for highly specific detection of serine is described. Using two-dimensional fluorescence spectrometry, a non-invasive method for the determination of several product fractions could be established in an industrial chromatographic procedure.
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Fischer L, Harlé V, Kasztelan S, d'Espinose de la Caillerie JB. Identification of fluorine sites at the surface of fluorinated gamma-alumina by two-dimensional MAS NMR. SOLID STATE NUCLEAR MAGNETIC RESONANCE 2000; 16:85-91. [PMID: 10811433 DOI: 10.1016/s0926-2040(00)00058-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
By means of 27Al triple quantum Magic-Angle Spinning Nuclear Magnetic Resonance (3QMAS NMR) and 27Al[19F] WISE MAS NMR, we were able to detect three different Al-F sites on the surface of fluorinated gamma-alumina. Three 19F resonances at 9, 20, and 33 ppm (from C6F6) correlated to 27Al resonances in the octahedral range. While the positions of the maxima in the 27Al dimension were ill-defined due to the inherently low efficiency of the 27Al[19F] CPMAS process, the center of gravity of the lines shifted significantly upfield in that dimension with increasing wt.% F. Tentatively, these three resonances were assigned to (VI)Al(O(6-n)Fn) (n = 1, 2, 3) environments on the F/gamma-Al2O3 surface. At F contents above levels corresponding to the full fluorination of the gamma-Al2O3 surface, neoformation of an AlF3 x 3H2O phase was also evidenced with an 19F resonance at -8 ppm and with an 27Al resonance at -17 ppm.
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Fischer L, Klimke J, Wulff H. Temperature and Time Resolved Studies of the Titanium Silicide Formatin with GIXRD abd GIXR. MATERIALS SCIENCE FORUM 2000; 321-324:392-399. [DOI: 10.4028/www.scientific.net/msf.321-324.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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204
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Fischer L, Sterneck M, Claus M, Costard-Jäckle A, Fleischer B, Herbst H, Rogiers X, Broelsch CE. Transmission of malaria tertiana by multi-organ donation. Clin Transplant 1999; 13:491-5. [PMID: 10617239 DOI: 10.1034/j.1399-0012.1999.130609.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In this report, transmission of malaria via a liver, a kidney, and possibly a heart allograft from a single donor is described. The donor had immigrated from Cameroon to Germany 18 months before, but had no clinical signs of active malaria infection. The liver transplant recipient and one of the two kidney transplant patients developed febrile illness with the appearance of Plasmodium vivax in blood smears 5 and 6 wk after transplantation, respectively. In the heart transplant recipient, a subclinical malaria infection was suspected based on a rise of malaria antibodies late after transplantation, whereas the recipient of the second kidney allograft had no clinical or laboratory evidence of malaria. Both liver and kidney recipients with active malaria responded to medical treatment. However, the liver transplant patient developed progressive cholestasis and died 5 months after transplantation from liver failure possibly due to side effects of the malaria medication. Other cases of malaria in solid organ recipients are briefly reviewed.
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206
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Fischer L. [Examining the shoulder in general practice]. PRAXIS 1999; 88:1815-1824. [PMID: 10584552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
When the cause of pain or the loss of function lies in the shoulder area itself, in most cases it can be related to a certain anatomical structure by means of a precise clinical examination. The individual tests are depicted in illustrations and concise texts. As a memory aid, the structure being tested has been added in each picture. Also, the clinically most relevant trigger points are depicted, along with their corresponding pseudoradicular symptomatology (referred pain). The aim of this article is to assist in the day-to-day treatment of common shoulder problems.
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207
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Dozet A, Fischer L. Incentives for diffusion of new health care technology. DEVELOPMENTS IN HEALTH ECONOMICS AND PUBLIC POLICY 1999; 7:161-85. [PMID: 10538828 DOI: 10.1007/978-1-4615-4052-6_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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208
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Peissker F, Fischer L. Crosslinking of imprinted proteases to maintain a tailor-made substrate selectivity in aqueous solutions. Bioorg Med Chem 1999; 7:2231-7. [PMID: 10579531 DOI: 10.1016/s0968-0896(99)00156-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A covalent method to keep imprinted properties of proteins stable in aqueous as well as in organic environment is described. To stabilize the ligand induced acceptance for D-configured substrates by alpha-chymotrypsin or subtilisin Carlsberg, each protein was first vinylated by acylation with itaconic anhydride. Then, the tailoring of the derivatized proteins by precipitation in the presence of N-acetyl-D-tryptophan from an aqueous medium with 1-propanol, and the subsequent crosslinking of the enzyme preparations with ethylene glycol dimethacrylate in cyclohexane was carried out. The crosslinked imprinted proteins (CLIPs) obtained catalyzed the hydrolysis of N-acetyl-D-tryptophan ethyl ester in phosphate buffer and the corresponding back reaction in cyclohexane, respectively. The repeated use of CLIP-alpha-chymotrypsin in D-ester hydrolysis was demonstrated. Furthermore, this particular CLIP-alpha-chymotrypsin showed no loss in activity when it subsequently was used in the synthesis of N-acetyl-D-tryptophan ethyl ester in cyclohexane again. In the case of D-ester hydrolysis the reaction rate acceleration (k(enz)/k(nonenz)) was in the same order of magnitude of about 10(4)-10(5) mM(-1) for the two CLIP-proteases. The results suggest that enzymes tailored by imprinting technique do not lose their induced "new" property in the presence of water when they are prepared according to the described vinylation/crosslinking method (CLIP technique).
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209
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Somasundaram C, Takamatsu H, Andréoni C, Audonnet JC, Fischer L, Lefèvre F, Charley B. Enhanced protective response and immuno-adjuvant effects of porcine GM-CSF on DNA vaccination of pigs against Aujeszky's disease virus. Vet Immunol Immunopathol 1999; 70:277-87. [PMID: 10507367 DOI: 10.1016/s0165-2427(99)00085-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was conducted to investigate whether the co-delivery of DNA encoding porcine cytokines would enhance a protective immune response in pigs to a Pseudorabies virus (PRV; or Aujeszky's disease virus) DNA vaccine. Aujeszky's disease in pigs results in respiratory and nervous symptoms with important economic losses. To evaluate cytokine effects, eukaryotic expression vectors were constructed for porcine GM-CSF, IL-2 and IFN-gamma. cDNA for each of these cytokines was inserted under the control of a CMV promoter in the pcDNA3 plasmid and cytokine expression was confirmed after DNA transfection in various mammalian cell cultures by bioassays (GM-CSF and IL2) and ELISA (IFN-gamma). Pigs were vaccinated by single intramuscular injection with plasmid DNA encoding PRV gB and gD along with various combinations of cytokine plasmid constructs. Pig serum was tested for the production of antibody by isotype specific anti-PRV ELISA. Pigs were then challenged with the highly virulent PRV strain NIA3 on day 21 after vaccination. The survival and growth rate of pigs were monitored for seven days after the viral challenge. The co-administration of GM-CSF plasmid increased the immune response induced by gB and gD PRV DNA vaccine. This immune response was characterized by an earlier appearance of anti-PRV IgG2, a significantly enhanced anti-PRV IgG1 and IgG2 antibody response, a significantly decreased and shortened viral excretion in nasal swabs and an improved protection to the viral challenge. In contrast, the co-administration of porcine IL-2 or IFN-gamma had no adjuvant effects. Our results thus demonstrate for the first time that the application of porcine GM-CSF gene in a DNA vaccine formulation can exert immuno-adjuvant and protective effects with single vaccination in the natural host pig against Aujeszky's disease.
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Abstract
Under conservative management, the mortality rate of acute liver failure is very high. Liver transplantation is an established life-saving therapy, offering survival rates between 60 and 90%. The decision for liver transplantation should be based on prognostic criteria, including patient's age, aetiology of liver disease, degree and onset of encephalopathy, serum bilirubin, prothrombin time or international normalized ratio (INR), serum creatinine, factor V level and arterial pH. Auxiliary liver transplantation is becoming an attractive treatment modality, allowing temporary bridging of liver function until recovery of the native liver. For children with acute liver failure, living related transplantation represents an additional option. In adult patients, living donation is not yet established since the maximum extent of liver resection safely tolerated and the amount of liver tissue necessary for sufficient graft function is still a matter of debate.
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211
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Bachmann C, Fischer L, Walter U, Reinhard M. The EVH2 domain of the vasodilator-stimulated phosphoprotein mediates tetramerization, F-actin binding, and actin bundle formation. J Biol Chem 1999; 274:23549-57. [PMID: 10438535 DOI: 10.1074/jbc.274.33.23549] [Citation(s) in RCA: 232] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vasodilator-stimulated phosphoprotein (VASP) is a member of the Ena/VASP family of proteins that are implicated in regulation of the actin cytoskeleton. All family members share a tripartite structural organization, comprising an N-terminal Ena/VASP homology (EVH) 1 domain, a more divergent proline-rich central part, and a common C-terminal EVH2 region of about 160-190 amino acids. Using chemical cross-linking, sucrose gradient sedimentation, and gel filtration analyses of different truncated VASP constructs, we demonstrate that the VASP EVH2 region is both necessary and sufficient for tetramerization. Moreover, co-sedimentation and fluorescent phalloidin staining showed that the EVH2 region binds and bundles F-actin in vitro and localizes to stress fibers in transfected cells. Analysis of the functional contribution of highly conserved blocks within this region indicated that residues 259-276 of human VASP are essential for the interaction with F-actin, whereas residues 343-380 are required for tetramerization, probably via coiled-coil formation. Interactions with F-actin are enhanced by VASP tetramerization. The results demonstrate that the C-terminal EVH2 segment is not only conserved in sequence but also forms a distinct functional entity. The data suggest that the EVH2 segment represents a novel oligomerization and F-actin binding domain.
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212
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Gabler M, Fischer L. Production of a new D-amino acid oxidase from the fungus Fusarium oxysporum. Appl Environ Microbiol 1999; 65:3750-3. [PMID: 10427080 PMCID: PMC91565 DOI: 10.1128/aem.65.8.3750-3753.1999] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The fungus Fusarium oxysporum produced a D-amino acid oxidase (EC 1. 4.3.3) in a medium containing glucose as the carbon and energy source and ammonium sulfate as the nitrogen source. The specific D-amino acid oxidase activity was increased up to 12.5-fold with various D-amino acids or their corresponding derivatives as inducers. The best inducers were D-alanine (2.7 microkat/g of dry biomass) and D-3-aminobutyric acid (2.6 microkat/g of dry biomass). The addition of zinc ions was necessary to permit the induction of peroxisomal D-amino acid oxidase. Bioreactor cultivations were performed on a 50-liter scale, yielding a volumetric D-amino acid oxidase activity of 17 microkat liter(-1) with D-alanine as an inducer. Under oxygen limitation, the volumetric activity was increased threefold to 54 microkat liter(-1) (3,240 U liter(-1)).
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213
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Fischer L, Smith G. Statistical adequacy of the Abel Assessment for Interest in Paraphilias. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 1999; 11:195-205. [PMID: 10497779 DOI: 10.1177/107906329901100303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A review of the psychometric properties of the Abel Assessment for Interest in Paraphilias (AAIP) is presented. The data supporting the AAIP's history, purpose, data, reliability, validity, and norms are reported, with the conclusion that its use with adults is tenuous at best and its use with adolescents is as yet unsupported. Pragmatic concerns are noted, along with recommendations for further research.
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214
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Smith G, Fischer L. Assessment of juvenile sexual offenders: reliability and validity of the Abel Assessment for Interest in Paraphilias. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 1999; 11:207-216. [PMID: 10497780 DOI: 10.1177/107906329901100304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Empirical tests of the reliability and validity of the Abel Assessment for Interest in Paraphilias (AAIP) as used with juvenile sexual offenders were performed. Test-retest reliability, screening validity, and diagnostic validity were assessed using several analytical approaches. The temporal stability, sensitivity, and specificity of the AAIP as used with adolescents in residential and day treatment were not demonstrated. The results indicate the need for further refinement of the AAIP.
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215
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Günther S, Fischer L, Pult I, Sterneck M, Will H. Naturally occurring variants of hepatitis B virus. Adv Virus Res 1999; 52:25-137. [PMID: 10384235 DOI: 10.1016/s0065-3527(08)60298-5] [Citation(s) in RCA: 189] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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216
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Günther S, von Breunig F, Santantonio T, Jung MC, Gaeta GB, Fischer L, Sterneck M, Will H. Absence of mutations in the YMDD motif/B region of the hepatitis B virus polymerase in famciclovir therapy failure. J Hepatol 1999; 30:749-54. [PMID: 10365797 DOI: 10.1016/s0168-8278(99)80124-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Nucleoside analogues such as lamivudine and famciclovir are potent drugs for treatment of chronic hepatitis B virus infection. Breakthrough infections during lamivudine therapy are associated with mutations in the YMDD motif and putative B region of the HBV polymerase. This study investigated whether failure of famciclovir therapy is also associated with presence or emergence of particular mutations in the HBV polymerase. METHODS We analyzed longitudinally the sequence of the priming and polymerase domain in seven patients with primary non-response to therapy and two patients with a breakthrough during therapy. Two patients who responded to therapy served as a control. RESULTS The YMDD motif and the B region were conserved in all isolates. V-->I changes at position 555 just downstream of the YMDD motif were observed before and during therapy in a virus subpopulation of two patients with a primary non-response. In patients with a breakthrough, 378-V-->I and 424-N-->D mutations emerged in the N terminal part of the polymerase domain during follow-up. Lamivudine rescue therapy initiated in four patients, including a patient infected with YMDD(555-V-->I) variants, efficiently reduced viremia. CONCLUSIONS These data indicate that failure of famciclovir therapy can occur independently of mutations in the YMDD motif or B region of the HBV polymerase and provide a rationale for rescue therapy with lamivudine.
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217
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Fischer L. [To the biography of Géza Dabasi Halász]. Orv Hetil 1999; 140:859-60. [PMID: 10323077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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218
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Stokrová J, Palková Z, Fischer L, Richterová Z, Korb J, Griffin BE, Forstová J. Interactions of heterologous DNA with polyomavirus major structural protein, VP1. FEBS Lett 1999; 445:119-25. [PMID: 10069385 DOI: 10.1016/s0014-5793(99)00003-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
'Empty' polyomavirus pseudocapsids, self-assembled from the major structural protein VP1, bind DNA non-specifically and can deliver it into the nuclei of mammalian cells for expression [Forstová et al. (1995) Hum. Gene Ther. 6, 297-3061. Formation of suitable VP1-DNA complexes appears to be the limiting step in this route of gene delivery. Here, the character of VP1-DNA interactions has been studied in detail. Electron microscopy revealed that VP1 pseudocapsids can create in vitro at least two types of interactions with double-stranded DNA: (i) highly stable complexes, requiring free DNA ends, where the DNA is partially encapsidated; and, (ii) weaker interactions of pseudocapsids with internal parts of the DNA chain.
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Fischer L, Sterneck M, Müller-Ruchholtz C, Gish R, Will H. Hepatitis B virus variants associated with clinically severe recurrence after liver transplantation. Transplant Proc 1999; 31:492-3. [PMID: 10083206 DOI: 10.1016/s0041-1345(98)01724-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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220
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Fischer L, Sterneck M, Feucht HH, Schuhmacher C, Malagó M, Rogiers X, Laufs R, Broelsch CE. Hepatitis G virus infection in liver transplant recipients. Transplant Proc 1999; 31:496-9. [PMID: 10083208 DOI: 10.1016/s0041-1345(98)01726-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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221
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Fischer L, Sterneck M, Valentin-Gamazo C, Feucht HH, Malagó M, Broelsch CE. Treatment of severe recurrent hepatitis C after liver transplantation with ribavirin plus interferon alpha. Transplant Proc 1999; 31:494-5. [PMID: 10083207 DOI: 10.1016/s0041-1345(98)01725-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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222
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Sosnitza P, Irtel F, Ulber R, Busse M, Faurie R, Fischer L, Scheper T. Flow injection analysis system for the supervision of industrial chromatographic downstream processing in biotechnology. Biosens Bioelectron 1998; 13:1251-5. [PMID: 9883558 DOI: 10.1016/s0956-5663(98)00084-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sugar beet molasses is a natural resource for various products used in daily life, ranging from sucrose to amino acids for pharmaceutical industry. The separation of molasses into these high value components is performed on a large scale by ion exchange/exclusion chromatography. A biosensor system was set up for the "in time" analysis of serine and sucrose during molasses desugarisation. D-Serine was analysed with the multi-enzyme system D-serine dehydratase/lactic dehydrogenase and photometric detection of the NADH consumed. Sucrose was determined with invertase/mutarotase/glucose oxidase and the oxygen consumed was monitored amperometrically. An analysis could be performed within 2-5 min by directly injecting samples from the chromatographic process into the flow injection analysis system. The determination range for the sucrose analysis was 0-2.5 gl-1 and for the analysis of D-serine 0-0.5 gl-1. The standard deviation for the measurement of D-serine was 1.7%.
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223
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Sterneck M, Kalinina T, Günther S, Fischer L, Santantonio T, Greten H, Will H. Functional analysis of HBV genomes from patients with fulminant hepatitis. Hepatology 1998; 28:1390-7. [PMID: 9794926 DOI: 10.1002/hep.510280530] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Two previous case reports suggest that hepatitis B virus (HBV) core promoter variants with a high replication competence contribute to the pathogenesis of fulminant hepatitis B (FHB). We recently found in HBV genomes from patients with FHB an accumulation of mutations within the core promoter region. Therefore, the aim of this study was to investigate the phenotype of these HBV variants. Replication competence and expression of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) of viral genomes from seven patients with FHB and one patient with fulminant recurrent hepatitis after liver transplantation were analyzed by transfection experiments in human hepatoma cells. Compared with wild-type virus, the HBV variants from the seven patients with FHB produced similar or slightly lower levels of intracellular replicative intermediates and extracellular viral particles. In contrast, the HBV genomes from the patient with fulminant recurrent hepatitis synthesized and secreted significantly more HBV DNA. All genomes tested expressed similar or even higher levels of HBeAg compared with wild-type virus, except for those from four patients with a precore stop codon mutation in the respective dominant viral populations. The level of HBsAg produced by all variant genomes was similar or reduced compared with wild-type virus. These data indicate that in some cases HBV variants with enhanced replication competence and/or a defect in HBeAg expression may contribute to the development of FHB. However, neither phenotype is an essential prerequisite; thus, an additional role of other viral or host factors in the pathogenesis of FHB is suggested.
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Fischer L, Grammont P, Farizon F. [Gilles Bousquet. (1936-1996)]. ANNALES DE CHIRURGIE 1998; 52:121-2. [PMID: 9752426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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225
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Seinost G, Gasser R, Reisinger E, Rigler MY, Fischer L, Keplinger A, Dattwyler RJ, Dunn JJ, Klein W. [Cardiac manifestations of Lyme borreliosis with special reference to contractile dysfunction]. ACTA MEDICA AUSTRIACA 1998; 25:44-50. [PMID: 9681041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Borrelia burgdorferi infection (BBI) is suggested to be associated with dilated cardiomyopathy (IDC). Stanek et al. were able to cultivate Borrelia burgdorferi (BB) from myocardial biopsy tissue of a patient with longstanding dilated cardiomyopathy. Here we present a study in which we examined the effect of standard antibiotic treatment on the left ventricular ejection fraction (LV-EF) in patients with dilated cardiomyopathy associated with BBI. In this study we assessed the serum (IgG, IgM ELISA; Western Blot) and the history of 46 IDC-patients with specific respect spect to BBI (mean LV-EF: 30.4 +/- 1.3%; measured by cardiac catheterisation and echocardiography--length-area-volume method). All 46 patients received standard treatment for dilated cardiomyopathy: ACE-inhibitors, digitalis and diuretics. 11 (24%) patients showed positive serology and a history of BBI; 9 of these also had a typical history of tick bite and erythema chronicum migrans (ECM) and/or other organ involvement, 2 had no recollection of tick bite or EMC, but showed other BB-associated disorders (neuropathy, oligoarthritis). These 11 patients with BBI received standard antibiotic treatment with intravenous ceftriaxone 2 g bid for 14 days. 6 (55%) recovered completely and showed a normal LV-EF after 6 months, 3 (27%) improved their LV-EF and 2 (18%) did not improve at all. This amounts to 9 (82%) recovery/improvement in the BB-group. The 35 patients who did not show positive serology or a history of BBI did not receive antibiotic treatment. In this group without BBI 12 (26%) showed recovery/improvement following the standard treatment of dilated cardiomyopathy (see above). Our results indicate that BBI could play a decisive role in the development of dilated cardiomyopathy, especially in a geographical region as Graz, where BB is endemic. While aware of the small number of BB-patients in this study, we nevertheless conclude that, in a remarkable number of patients with signs of BBI, dilated cardiomyopathy could be reversed and LV-EF improved upon standard antibiotic treatment.
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