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Schwartz T, Hoornstra D, Øie E, Hovius J, Quarsten H. Case report: First case of Borrelia miyamotoi meningitis in an immunocompromised patient in Norway. IDCases 2023; 33:e01867. [PMID: 37577049 PMCID: PMC10412827 DOI: 10.1016/j.idcr.2023.e01867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/30/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023] Open
Abstract
Background Tick-borne disease caused by B. miyamotoi (BMD) usually manifest as a febrile illness in humans. Complications include relapsing fever and in rare occasions involvement of the central nervous system. Only a few cases of meningoencephalitis have been described, mostly in immunosuppressed patients. Case presentation A 70-year-old female receiving immunosuppressive rituximab therapy presented with frontal headache, dizziness, nausea, vomiting and chills. Clinical laboratory blood analyses were normal. Cerebrospinal fluid (CSF) was translucent and analysis showed increased leucocyte count (187 106/L) and elevated level of protein (1056 mg/L). Empiric antibiotic treatment was initiated. The patient showed an early symptomatic relief and 24 h after admission she was discharged from the hospital and antibiotic treatment was discontinued. Two weeks after hospitalisation the B. miyamotoi specific PCR turned out positive in both CSF and serum. At the time, the patient was recovered with mild residual headache. She was treated with high dose doxycycline and her subtle symptoms disappeared. Conclusions To our knowledge, we present the first patient with BMD-associated meningitis in Norway, one of eight cases reported worldwide. The patient had mild symptoms and received an early diagnosis. A more severe progression or relapse of disease may have been prevented by antibiotic treatment. BMD should be considered as causes of aseptic meningitis, especially in immunosuppressed patients living in endemic areas.
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Affiliation(s)
- Thomas Schwartz
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
- Oslo New University College, Oslo, Norway
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Erik Øie
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Joppe Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Hanne Quarsten
- Department of Medical Microbiology, Sørlandet Hospital, Kristiansand, Norway
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Hoornstra D, Stukolova OA, Karan LS, Sarksyan DS, Kolyasnikova NM, Markelov ML, Cherkashina AS, Dolgova AS, Sudina AE, Sokolova MI, Platonov AE, Hovius JW. Development and Validation of a Protein Array for Detection of Antibodies against the Tick-Borne Pathogen Borrelia miyamotoi. Microbiol Spectr 2022; 10:e0203622. [PMID: 36314925 PMCID: PMC9769530 DOI: 10.1128/spectrum.02036-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/26/2022] [Indexed: 11/06/2022] Open
Abstract
Current serological tests for the emerging tick-borne pathogen Borrelia miyamotoi lack diagnostic accuracy. To improve serodiagnosis, we investigated a protein array simultaneously screening for IgM and IgG reactivity against multiple recombinant B. miyamotoi antigens. The array included six B. miyamotoi antigens: glycerophosphodiester phosphodiesterase (GlpQ), multiple variable major proteins (Vmps), and flagellin. Sera included samples from cases of PCR-proven Borrelia miyamotoi disease (BMD), multiple potentially cross-reactive control groups (including patients with culture-proven Lyme borreliosis, confirmed Epstein-Barr virus, cytomegalovirus, or other spirochetal infections), and several healthy control groups from regions where Ixodes is endemic and regions where it is nonendemic. Based on receiver operating characteristic (ROC) analyses, the cutoff for reactivity per antigen was set at 5 μg/mL for IgM and IgG. The individual antigens demonstrated high sensitivity but relatively low specificity for both IgM and IgG. The best-performing single antigen (GlpQ) showed a sensitivity of 88.0% (95% confidence interval [CI], 78.9 to 93.5) and a specificity of 94.2% (95% CI, 92.7 to 95.6) for IgM/IgG. Applying the previous published diagnostic algorithm-defining seroreactivity as reactivity against GlpQ and any Vmp-revealed a significantly higher specificity of 98.5% (95% CI, 97.6 to 99.2) but a significantly lower sensitivity of 79.5% (95% CI, 69.3 to 87.0) for IgM/IgG compared to GlpQ alone. Therefore, we propose to define seroreactivity as reactivity against GlpQ and any Vmp or flagellin which resulted in a comparable sensitivity of 84.3% (95% CI, 74.7 to 90.8) and a significantly higher specificity of 97.9% (95% CI, 96.9 to 98.7) for IgM/IgG compared to GlpQ alone. In conclusion, we have developed and validated a novel serological tool to diagnose BMD that could be implemented in clinical practice and epidemiological studies. IMPORTANCE This paper describes the protein array as a novel serological test for the diagnosis of Borrelia miyamotoi disease (BMD), by reporting the methodology, the development of a diagnostic algorithm, and its extensive validation. With rising numbers of ticks and tick bites, tick-borne diseases, such as BMD, urgently deserve further societal and medical attention. B. miyamotoi is prevalent in Ixodes ticks across the northern hemisphere. Humans are exposed to, and infected by, B. miyamotoi and develop BMD in Asia, in North America, and to a lesser extent in Europe. However, the burden of infection and disease remains largely unknown, due to the noncharacteristic clinical presentation, together with the lack of awareness and availability of diagnostic tools. With this paper, we offer a novel diagnostic tool which will assist in assessing the burden of disease and could be implemented in clinical care.
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Affiliation(s)
- Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | | | | | | | - Nadezhda M. Kolyasnikova
- Central Research Institute of Epidemiology, Moscow, Russia
- Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Russian Academy of Sciences, Moscow, Russia
| | | | | | - Anna S. Dolgova
- St. Petersburg Pasteur Institute of Epidemiology and Microbiology, Saint Petersburg, Russia
| | - Anna E. Sudina
- Central Research Institute of Epidemiology, Moscow, Russia
| | | | | | - Joppe W. Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
- Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
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Arora G, Lynn GE, Tang X, Rosen CE, Hoornstra D, Sajid A, Hovius JW, Palm NW, Ring AM, Fikrig E. CD55 Facilitates Immune Evasion by Borrelia crocidurae, an Agent of Relapsing Fever. mBio 2022; 13:e0116122. [PMID: 36036625 PMCID: PMC9600505 DOI: 10.1128/mbio.01161-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/19/2022] [Indexed: 11/20/2022] Open
Abstract
Relapsing fever, caused by diverse Borrelia spirochetes, is prevalent in many parts of the world and causes significant morbidity and mortality. To investigate the pathoetiology of relapsing fever, we performed a high-throughput screen of Borrelia-binding host factors using a library of human extracellular and secretory proteins and identified CD55 as a novel host binding partner of Borrelia crocidurae and Borrelia persica, two agents of relapsing fever in Africa and Eurasia. CD55 is present on the surface of erythrocytes, carries the Cromer blood group antigens, and protects cells from complement-mediated lysis. Using flow cytometry, we confirmed that both human and murine CD55 bound to B. crocidurae and B. persica. Given the expression of CD55 on erythrocytes, we investigated the role of CD55 in pathological B. crocidurae-induced erythrocyte aggregation (rosettes), which enables spirochete immune evasion. We showed that rosette formation was partially dependent on host cell CD55 expression. Pharmacologically, soluble recombinant CD55 inhibited erythrocyte rosette formation. Finally, CD55-deficient mice infected with B. crocidurae had a lower pathogen load and elevated proinflammatory cytokine and complement factor C5a levels. In summary, our results indicate that CD55 is a host factor that is manipulated by the causative agents of relapsing fever for immune evasion. IMPORTANCE Borrelia species are causative agents of Lyme disease and relapsing fever infections in humans. B. crocidurae causes one of the most prevalent relapsing fever infections in parts of West Africa. In the endemic regions, B. crocidurae is present in ~17% of the ticks and ~11% of the rodents that serve as reservoirs. In Senegal, ~7% of patients with acute febrile illness were found to be infected with B. crocidurae. There is little information on host-pathogen interactions and how B. crocidurae manipulates host immunity. In this study, we used a high-throughput screen to identify host proteins that interact with relapsing fever-causing Borrelia species. We identified CD55 as one of the host proteins that bind to B. crocidurae and B. persica, the two causes of relapsing fever in Africa and Eurasia. We show that the interaction of B. crocidurae with CD55, present on the surface of erythrocytes, is key to immune evasion and successful infection in vivo. Our study further shows the role of CD55 in complement regulation, regulation of inflammatory cytokine levels, and innate immunity during relapsing fever infection. Overall, this study sheds light on host-pathogen interactions during relapsing fever infection in vivo.
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Affiliation(s)
- Gunjan Arora
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Geoffrey E. Lynn
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Xiaotian Tang
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Connor E. Rosen
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dieuwertje Hoornstra
- Amsterdam UMC, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam, Netherlands
| | - Andaleeb Sajid
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Joppe W. Hovius
- Amsterdam UMC, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam, Netherlands
| | - Noah W. Palm
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Aaron M. Ring
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Hoornstra D, Azagi T, van Eck JA, Wagemakers A, Koetsveld J, Spijker R, Platonov AE, Sprong H, Hovius JW. Prevalence and clinical manifestation of Borrelia miyamotoi in Ixodes ticks and humans in the northern hemisphere: a systematic review and meta-analysis. Lancet Microbe 2022; 3:e772-e786. [PMID: 36113496 DOI: 10.1016/s2666-5247(22)00157-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/30/2022] [Accepted: 05/31/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Various studies have evaluated the infection of Ixodes ticks and humans with the relapsing fever spirochaete Borrelia miyamotoi. However, to our knowledge, the prevalence of infection and disease has not been assessed systematically. We aimed to examine the prevalence of B miyamotoi in Ixodes ticks and humans, and the disease it can cause, in the northern hemisphere. METHODS For this systematic review and meta-analysis, we searched PubMed and Web of Science up to March 1, 2021. Studies assessing Ixodes tick infection published since Jan 1, 2011 were eligible, whereas no time limitation was placed on reports of human infection and disease. We extracted B miyamotoi test positivity ratios and used a random-effects model to calculate estimated proportions of infected ticks, infected humans, and human disease with 95% CI. This study was registered with PROSPERO, CRD42021268996. FINDINGS We identified 730 studies through database searches and 316 additional studies that referenced two seminal articles on B miyamotoi. Of these 1046 studies, 157 were included in the review, reporting on 165 637 questing ticks, 45 608 unique individuals, and 504 well described cases of B miyamotoi disease in humans. In ticks, the highest prevalence of B miyamotoi was observed in Ixodes persulcatus (2·8%, 95% CI 2·4-3·1) and the lowest in Ixodes pacificus (0·7%, 0·6-0·8). The overall seroprevalence in humans was 4·4% (2·8-6·3), with significantly (p<0·0001) higher seroprevalences in the high-risk group (4·6%, 2·6-7·1), participants with confirmed or suspected Lyme borreliosis (4·8%, 1·8-8·8), and individuals suspected of having a different tick-borne disease (11·9%, 5·6-19·9) than in healthy controls (1·3%, 0·4-2·8). Participants suspected of having a different tick-borne disease tested positive for B miyamotoi by PCR significantly more often than did the high-risk group (p=0·025), with individuals in Asia more likely to test positive than those in the USA (odds ratio 14·63 [95% CI 2·80-76·41]). INTERPRETATION B miyamotoi disease should be considered an emerging infectious disease, especially in North America and Asia. Prospective studies and increased awareness are required to obtain further insights into the burden of disease. FUNDING ZonMW and the European Regional Development Fund (Interreg).
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Affiliation(s)
- Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Tal Azagi
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jacqueline A van Eck
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Alex Wagemakers
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Joris Koetsveld
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - René Spijker
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | - Hein Sprong
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands; Amsterdam Institute for Infection and Immunity, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands.
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Azagi T, Harms M, Swart A, Fonville M, Hoornstra D, Mughini-Gras L, Hovius JW, Sprong H, van den Wijngaard C. Self-reported symptoms and health complaints associated with exposure to Ixodes ricinus-borne pathogens. Parasit Vectors 2022; 15:93. [PMID: 35303944 PMCID: PMC8931963 DOI: 10.1186/s13071-022-05228-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of infections with tick-borne pathogens (TBPs) other than Borrelia burgdorferi (s.l.) and tick-borne encephalitis virus (TBEV) on public health in Europe remains unclear. Our goal is to evaluate whether the presence of these TBPs in ticks can be associated with self-reported health complaints. METHODS We enrolled individuals who were bitten by I. ricinus between 2012 and 2015 and collected their relevant demographic and clinical information using a self-administered online questionnaire. A total of 4163 I. ricinus ticks sent by the participants were subject to molecular analyses for detection of specific TBPs. Associations between the presence of TBPs in ticks and self-reported complaints and symptoms were evaluated by means of a stepwise approach using a generalized linear model (GLM). RESULTS Of 17 self-reported complaints and symptoms significant in the univariate analyses, 3 had a highly significant association (P < 0.01) with at least one TBP in the multivariate analysis. Self-reported Lyme borreliosis was significantly associated (P < 0.001) with B. burgdorferi (s.l.) infection. Facial paralysis was associated (P < 0.01) with infection with B. miyamotoi, N. mikurensis and R. helvetica. Finally, a significant association (P < 0.001) was found between nocturnal sweating and A. phagocytophilum. CONCLUSIONS We found associations between the presence of TBPs in ticks feeding on humans and self-reported symptoms. Due to the subjective nature of such reports and the fact that infection was determined in the ticks and not in the patient samples, further prospective studies utilizing diagnostic modalities should be performed before any clinical outcome can be causally linked to infection with TBPs.
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Affiliation(s)
- Tal Azagi
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands.
| | - Margriet Harms
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| | - Arno Swart
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| | - Manoj Fonville
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Lapo Mughini-Gras
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Hein Sprong
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| | - Cees van den Wijngaard
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
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Hoornstra D, Harms MG, Gauw SA, Wagemakers A, Azagi T, Kremer K, Sprong H, van den Wijngaard CC, Hovius JW. Ticking on Pandora's box: a prospective case-control study into 'other' tick-borne diseases. BMC Infect Dis 2021; 21:501. [PMID: 34051756 PMCID: PMC8164744 DOI: 10.1186/s12879-021-06190-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tick-borne pathogens other than Borrelia burgdorferi sensu lato - the causative agent of Lyme borreliosis - are common in Ixodes ricinus ticks. How often these pathogens cause human disease is unknown. In addition, diagnostic tools to identify such diseases are lacking or reserved to research laboratories. To elucidate their prevalence and disease burden, the study 'Ticking on Pandora's Box' has been initiated, a collaborative effort between Amsterdam University Medical Center and the National Institute for Public Health and the Environment. METHODS The study investigates how often the tick-borne pathogens Anaplasma phagocytophilum, Babesia species, Borrelia miyamotoi, Neoehrlichia mikurensis, spotted fever group Rickettsia species and/or tick-borne encephalitis virus cause an acute febrile illness after tick-bite. We aim to determine the impact and severity of these tick-borne diseases in the Netherlands by measuring their prevalence and describing their clinical picture and course of disease. The study is designed as a prospective case-control study. We aim to include 150 cases - individuals clinically suspected of a tick-borne disease - and 3 matched healthy control groups of 200 persons each. The controls consist respectively of a group of individuals with either a tick-bite without complaints, the general population and of healthy blood donors. During a one-year follow-up we will acquire blood, urine and skin biopsy samples and ticks at baseline, 4 and 12 weeks. Additionally, participants answer modified versions of validated questionnaires to assess self-reported symptoms, among which the SF-36, on a 3 monthly basis. DISCUSSION This article describes the background and design of the study protocol of 'Ticking on Pandora's Box'. With our study we hope to provide insight into the prevalence, clinical presentation and disease burden of the tick-borne diseases anaplasmosis, babesiosis, B. miyamotoi disease, neoehrlichiosis, rickettsiosis and tick-borne encephalitis and to assist in test development as well as provide recommendations for national guidelines. TRIAL REGISTRATION NL9258 (retrospectively registered at Netherlands Trial Register, trialregister.nl in in February 2021).
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Affiliation(s)
- D Hoornstra
- Amsterdam UMC, Center for Experimental and Molecular Medicine, Amsterdam Institute of Infection and Immunology, University of Amsterdam, P.O. Box 22660 (1100 DD), Amsterdam, The Netherlands. .,National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands.
| | - M G Harms
- National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands
| | - S A Gauw
- Amsterdam UMC, Center for Experimental and Molecular Medicine, Amsterdam Institute of Infection and Immunology, University of Amsterdam, P.O. Box 22660 (1100 DD), Amsterdam, The Netherlands
| | - A Wagemakers
- Amsterdam UMC, Center for Experimental and Molecular Medicine, Amsterdam Institute of Infection and Immunology, University of Amsterdam, P.O. Box 22660 (1100 DD), Amsterdam, The Netherlands
| | - T Azagi
- National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands
| | - K Kremer
- National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands
| | - H Sprong
- National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands
| | - C C van den Wijngaard
- National Institute for Public Health and the Environment (RIVM), Center of Infectious Disease Control, P.O. Box 1 (3720 BA), Bilthoven, The Netherlands
| | - J W Hovius
- Amsterdam UMC, Center for Experimental and Molecular Medicine, Amsterdam Institute of Infection and Immunology, University of Amsterdam, P.O. Box 22660 (1100 DD), Amsterdam, The Netherlands
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Gupta A, Arora G, Rosen CE, Kloos Z, Cao Y, Cerny J, Sajid A, Hoornstra D, Golovchenko M, Rudenko N, Munderloh U, Hovius JW, Booth CJ, Jacobs-Wagner C, Palm NW, Ring AM, Fikrig E. A human secretome library screen reveals a role for Peptidoglycan Recognition Protein 1 in Lyme borreliosis. PLoS Pathog 2020; 16:e1009030. [PMID: 33175909 PMCID: PMC7657531 DOI: 10.1371/journal.ppat.1009030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
Lyme disease, the most common vector-borne illness in North America, is caused by the spirochete Borrelia burgdorferi. Infection begins in the skin following a tick bite and can spread to the hearts, joints, nervous system, and other organs. Diverse host responses influence the level of B. burgdorferi infection in mice and humans. Using a systems biology approach, we examined potential molecular interactions between human extracellular and secreted proteins and B. burgdorferi. A yeast display library expressing 1031 human extracellular proteins was probed against 36 isolates of B. burgdorferi sensu lato. We found that human Peptidoglycan Recognition Protein 1 (PGLYRP1) interacted with the vast majority of B. burgdorferi isolates. In subsequent experiments, we demonstrated that recombinant PGLYRP1 interacts with purified B. burgdorferi peptidoglycan and exhibits borreliacidal activity, suggesting that vertebrate hosts may use PGLYRP1 to identify B. burgdorferi. We examined B. burgdorferi infection in mice lacking PGLYRP1 and observed an increased spirochete burden in the heart and joints, along with splenomegaly. Mice lacking PGLYRP1 also showed signs of immune dysregulation, including lower serum IgG levels and higher levels of IFNγ, CXCL9, and CXCL10.Taken together, our findings suggest that PGLYRP1 plays a role in the host’s response to B. burgdorferi and further demonstrate the utility of expansive yeast display screening in capturing biologically relevant interactions between spirochetes and their hosts. Lyme disease is the most common vector-borne illness in North America and is caused by the spirochete Borrelia burgdorferi. The disease starts with a tick bite that leads to a skin rash and inflammation in other organs of the body, such as hearts and joints. B. burgdorferi uses many strategies to evade detection and persist in the human host. It is important to have efficient methods to be able to identify the various components of the immune system that interact with B. burgdorferi to better understand the disease process, but few currently exist. In this study, we used a novel yeast display screening assay of over 1,000 human immune proteins probed against several isolates of Borrelia to uncover biologically relevant interactions for the Lyme disease pathogen. We identified Peptidoglycan Recognition Protein 1 (PGLYRP1), an innate immune protein important in defense against bacteria, as a major candidate from this screen. We validated the interaction of PGLYRP1 with Borrelia and were able to use PGLYRP1-deficient mice as a model to understand the role of this protein in Lyme disease pathogenesis. Our study demonstrates the potential implications of yeast screens in uncovering important host-pathogen interactions.
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Affiliation(s)
- Akash Gupta
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Gunjan Arora
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Connor E. Rosen
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Zachary Kloos
- Microbiology Program, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Yongguo Cao
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Department of Clinical Veterinary Medicine, and Key Laboratory for Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, China
| | - Jiri Cerny
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Faculty of Tropical AgriSciences, Czech University of Life Sciences in Prague, Prague, Czech Republic
| | - Andaleeb Sajid
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Dieuwertje Hoornstra
- Amsterdam UMC, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam, Netherlands
| | - Maryna Golovchenko
- Biology Centre, Institute of Parasitology Czech Academy of Sciences, Buweiss, Czech Republic
| | - Natalie Rudenko
- Biology Centre, Institute of Parasitology Czech Academy of Sciences, Buweiss, Czech Republic
| | - Ulrike Munderloh
- Department of Entomology, University of Minnesota, St. Paul, Minnesota, United States of America
| | - Joppe W. Hovius
- Amsterdam UMC, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam, Netherlands
| | - Carmen J. Booth
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Christine Jacobs-Wagner
- Department of Biology, Stanford University, Stanford, California, United States of America
- ChEM-H Institute, Stanford University, Stanford, California, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
| | - Noah W. Palm
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail: (NWP); (AMR); (EF)
| | - Aaron M. Ring
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail: (NWP); (AMR); (EF)
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
- * E-mail: (NWP); (AMR); (EF)
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Henningsson AJ, Asgeirsson H, Hammas B, Karlsson E, Parke Å, Hoornstra D, Wilhelmsson P, Hovius JW. Two Cases of Borrelia miyamotoi Meningitis, Sweden, 2018. Emerg Infect Dis 2020; 25:1965-1968. [PMID: 31538916 PMCID: PMC6759261 DOI: 10.3201/eid2510.190416] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
We report 2 human cases of Borrelia miyamotoi disease diagnosed in Sweden, including 1 case of meningitis in an apparently immunocompetent patient. The diagnoses were confirmed by 3 different independent PCR assays and DNA sequencing from cerebrospinal fluid, supplemented by serologic analyses.
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Azagi T, Hoornstra D, Kremer K, Hovius JWR, Sprong H. Evaluation of Disease Causality of Rare Ixodes ricinus-Borne Infections in Europe. Pathogens 2020; 9:pathogens9020150. [PMID: 32102367 PMCID: PMC7168666 DOI: 10.3390/pathogens9020150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
In Europe, Ixodes ricinus ticks transmit pathogens such as Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV). In addition, there is evidence for transmission to humans from I. ricinus of Anaplasma phagocytophilum, Babesia divergens, Babesia microti, Babesia venatorum, Borrelia miyamotoi, Neoehrlichia mikurensis, Rickettsia helvetica and Rickettsia monacensis. However, whether infection with these potential tick-borne pathogens results in human disease has not been fully demonstrated for all of these tick-borne microorganisms. To evaluate the available evidence for a causative relation between infection and disease, the current study analyses European case reports published from 2008 to 2018, supplemented with information derived from epidemiological and experimental studies. The evidence for human disease causality in Europe found in this review appeared to be strongest for A. phagocytophilum and B. divergens. Nonetheless, some knowledge gaps still exist. Importantly, comprehensive evidence for pathogenicity is lacking for the remaining tick-borne microorganisms. Such evidence could be gathered best through prospective studies, for example, studies enrolling patients with a fever after a tick bite, the development of specific new serological tools, isolation of these microorganisms from ticks and patients and propagation in vitro, and through experimental studies.
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Affiliation(s)
- Tal Azagi
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
- Correspondence:
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Kristin Kremer
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
| | - Joppe W. R. Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Hein Sprong
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
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10
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Mason LMK, Koetsveld J, Trentelman JJA, Kaptein TM, Hoornstra D, Wagemakers A, Fikrig MM, Ersoz JI, Oei A, Geijtenbeek TBH, Hovius JWR. Borrelia miyamotoi Activates Human Dendritic Cells and Elicits T Cell Responses. J Immunol 2019; 204:386-393. [PMID: 31818980 DOI: 10.4049/jimmunol.1801589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 11/07/2019] [Indexed: 01/23/2023]
Abstract
The spirochete Borrelia miyamotoi has recently been shown to cause relapsing fever. Like the Lyme disease agent, Borrelia burgdorferi, B. miyamotoi is transmitted through the bite of infected ticks; however, little is known about the response of the immune system upon infection. Dendritic cells (DCs) play a central role in the early immune response against B. burgdorferi We investigated the response of DCs to two different strains of B. miyamotoi using in vitro and ex vivo models and compared this to the response elicited by B. burgdorferi. Our findings show that B. miyamotoi is phagocytosed by monocyte-derived DCs, causing upregulation of activation markers and production of proinflammatory cytokines in a similar manner to B. burgdorferi. Recognition of B. miyamotoi was demonstrated to be partially mediated by TLR2. DCs migrated out of human skin explants upon inoculation of the skin with B. miyamotoi. Finally, we showed that B. miyamotoi-stimulated DCs induced proliferation of naive CD4+ and CD8+ T cells to a larger extent than B. burgdorferi. In conclusion, we show in this study that DCs respond to and mount an immune response against B. miyamotoi that is similar to the response to B. burgdorferi and is able to induce T cell proliferation.
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Affiliation(s)
- Lauren M K Mason
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands;
| | - Joris Koetsveld
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Jos J A Trentelman
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Tanja M Kaptein
- Department of Experimental Immunology, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Alex Wagemakers
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Michelle M Fikrig
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Jasmin I Ersoz
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Anneke Oei
- Department of Medical Microbiology, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands; and
| | - Teunis B H Geijtenbeek
- Department of Experimental Immunology, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
| | - Joppe W R Hovius
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands.,Division of Infectious Diseases, Amsterdam Multidisciplinary Lyme Borreliosis Center, Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, the Netherlands
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11
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Koetsveld J, Platonov AE, Kuleshov K, Wagemakers A, Hoornstra D, Ang W, Szekeres S, van Duijvendijk GLA, Fikrig E, Embers ME, Sprong H, Hovius JW. Borrelia miyamotoi infection leads to cross-reactive antibodies to the C6 peptide in mice and men. Clin Microbiol Infect 2019; 26:513.e1-513.e6. [PMID: 31404672 DOI: 10.1016/j.cmi.2019.07.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/11/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Borrelia miyamotoi is a relapsing fever Borrelia, transmitted by hard (Ixodes) ticks, which are also the main vector for Borrelia burgdorferi. A widely used test for serodiagnosis of Lyme borreliosis is an enzyme immunoassay (EIA) based on the C6 peptide of the B. burgdorferi sl VlsE protein. We set out to study C6 reactivity upon infection with B. miyamotoi in a large well-characterized set of B. miyamotoi disease (BMD) patient sera and in experimental murine infection. METHODS We performed in silico analyses, comparing the C6-peptide to immunodominant B. miyamotoi variable large proteins (Vlps). Next, we determined C6 reactivity in sera from mice infected with B. miyamotoi and in a unique longitudinal set of 191 sera from 46 BMD patients. RESULTS In silico analyses revealed similarity of the C6 peptide to domains within B. miyamotoi Vlps. Cross-reactivity against the C6 peptide was confirmed in 21 out of 24 mice experimentally infected with B. miyamotoi. Moreover, 35 out of 46 BMD patients had a C6 EIA Lyme index higher than 1.1 (positive). Interestingly, 27 out of 37 patients with a C6 EIA Lyme index higher than 0.9 (equivocal) were negative when tested for specific B. burgdorferi sl antibodies using a commercially available immunoblot. CONCLUSIONS We show that infection with B. miyamotoi leads to cross-reactive antibodies to the C6 peptide. Since BMD and Lyme borreliosis are found in the same geographical locations, caution should be used when relying solely on C6 reactivity testing. We propose that a positive C6 EIA with negative immunoblot, especially in patients with fever several weeks after a tick bite, warrants further testing for B. miyamotoi.
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Affiliation(s)
- J Koetsveld
- AMC Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, the Netherlands.
| | - A E Platonov
- Central Research Scientific Institute of Epidemiology, Laboratory for Zoonoses, Moscow, Russia
| | - K Kuleshov
- Central Research Scientific Institute of Epidemiology, Laboratory for Zoonoses, Moscow, Russia
| | - A Wagemakers
- AMC Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, the Netherlands
| | - D Hoornstra
- AMC Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, the Netherlands
| | - W Ang
- VU University Medical Centre, Medical Microbiology and Infection Control, Amsterdam, the Netherlands
| | - S Szekeres
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases and Perinatal Screening, Bilthoven, the Netherlands
| | - G L A van Duijvendijk
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases and Perinatal Screening, Bilthoven, the Netherlands
| | - E Fikrig
- Yale University, Internal Medicine, New Haven, USA
| | - M E Embers
- Tulane University, Division of Bacteriology and Parasitology, Covington, USA
| | - H Sprong
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases and Perinatal Screening, Bilthoven, the Netherlands
| | - J W Hovius
- AMC Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, the Netherlands
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12
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Abstract
Borrelia miyamotoi disease is a hard tick–borne relapsing fever illness that occurs across the temperate climate zone. Human B. miyamotoi disease in immunocompetent patients has been described in Russia, North America, and Japan. We describe a case of B. miyamotoi disease in an immunocompetent patient in western Europe.
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13
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Koetsveld J, Kolyasnikova NM, Wagemakers A, Stukolova OA, Hoornstra D, Sarksyan DS, Toporkova MG, Henningsson AJ, Hvidsten D, Ang W, Dessau R, Platonov AE, Hovius JW. Serodiagnosis of Borrelia miyamotoi disease by measuring antibodies against GlpQ and variable major proteins. Clin Microbiol Infect 2018; 24:1338.e1-1338.e7. [PMID: 29550499 DOI: 10.1016/j.cmi.2018.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Borrelia miyamotoi disease (BMD) is an emerging tick-borne disease in the Northern hemisphere. Serodiagnosis by measuring antibodies against glycerophosphodiester-phosphodiesterase (GlpQ) has been performed experimentally but has not been extensively clinically validated. Because we had previously shown the differential expression of antigenic variable major proteins (Vmps) in B. miyamotoi, our aim was to study antibody responses against GlpQ and Vmps in PCR-proven BMD patients and controls. METHODS We assessed seroreactivity against GlpQ and four Vmps in a well-described, longitudinal cohort of sera from BMD patients (n=182), healthy blood donors (n=136) and controls (n=68). All samples were tested by ELISA and positive sera were tested by western blot, and antibody dynamics and diagnostic value were assessed. RESULTS IgM antibodies against GlpQ and Vmps peaked between 11 and 20 days, and IgG between 21 and 50 days, after disease onset. Various combinations of GlpQ and Vmps increased sensitivity and/or specificity compared to single antigens. Notably, the GlpQ or variable large protein (Vlp)-15/16 combination yielded a sensitivity of 94.7% (95% CI: 75.4-99.7) 11-20 days after disease onset and a specificity of 96.6% (92.7-98.4) for IgM. A specificity of 100% (97.8-100) for IgM, and 98.3% for IgG (95.2-100), was found when positivity was defined as reactivity to GlpQ and any Vmp, with maximum sensitivities of 79% (56.7-91.5) for IgM and 86.7% (62.1-97.6) for IgG. CONCLUSIONS We clearly demonstrate here the diagnostic potential of these seromarkers. Our findings will facilitate future epidemiological and clinical studies on BMD and lead to the development of a serologic test to be used in clinical practice.
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Affiliation(s)
- J Koetsveld
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | | | - A Wagemakers
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - O A Stukolova
- Central Research Institute of Epidemiology, Moscow, Russia
| | - D Hoornstra
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - D S Sarksyan
- Izhevsk State Medical Academy, Izhevsk, Udmurt Republic, Russia
| | - M G Toporkova
- Medical Association "Novaya Bolnitsa", Yekaterinburg, Russia
| | - A J Henningsson
- Department of Clinical Microbiology, County Hospital Ryhov, Jönköping, Sweden
| | - D Hvidsten
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway; Department of Laboratory Medicine, Nordland Hospital, Bodø, Norway
| | - W Ang
- Dept of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands
| | - R Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - A E Platonov
- Central Research Institute of Epidemiology, Moscow, Russia
| | - J W Hovius
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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14
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Sprong H, Azagi T, Hoornstra D, Nijhof AM, Knorr S, Baarsma ME, Hovius JW. Control of Lyme borreliosis and other Ixodes ricinus-borne diseases. Parasit Vectors 2018; 11:145. [PMID: 29510749 PMCID: PMC5840726 DOI: 10.1186/s13071-018-2744-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022] Open
Abstract
Lyme borreliosis (LB) and other Ixodes ricinus-borne diseases (TBDs) are diseases that emerge from interactions of humans and domestic animals with infected ticks in nature. Nature, environmental and health policies at (inter)national and local levels affect the risk, disease burden and costs of TBDs. Knowledge on ticks, their pathogens and the diseases they cause have been increasing, and resulted in the discovery of a diversity of control options, which often are not highly effective on their own. Control strategies involving concerted actions from human and animal health sectors as well as from nature managers have not been formulated, let alone implemented. Control of TBDs asks for a “health in all policies” approach, both at the (inter)national level, but also at local levels. For example, wildlife protection and creating urban green spaces are important for animal and human well-being, but may increase the risk of TBDs. In contrast, culling or fencing out deer decreases the risk for TBDs under specific conditions, but may have adverse effects on biodiversity or may be societally unacceptable. Therefore, in the end, nature and health workers together must carry out tailor-made control options for the control of TBDs for humans and animals, with minimal effects on the environment. In that regard, multidisciplinary approaches in environmental, but also medical settings are needed. To facilitate this, communication and collaboration between experts from different fields, which may include patient representatives, should be promoted.
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Affiliation(s)
- Hein Sprong
- Centre for Zoonoses & Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands. .,Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, the Netherlands.
| | - Tal Azagi
- Centre for Zoonoses & Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Ard M Nijhof
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Sarah Knorr
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - M Ewoud Baarsma
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
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15
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Honkalampi-Hämäläinen U, Bradley E, Castle L, Severin I, Dahbi L, Dahlman O, Lhuguenot JC, Andersson M, Hakulinen P, Hoornstra D, Mäki-Paakkanen J, Salkinoja-Salonen M, Turco L, Stammati A, Zucco F, Weber A, von Wright A. Safety evaluation of food contact paper and board using chemical tests and in vitro bioassays: role of known and unknown substances. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:406-15. [DOI: 10.1080/19440040903401358] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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16
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Bradley E, Stammati A, Salkinoja-Salonen M, Andersson M, Bertaud F, Hoornstra D, Zucco F, Weber A, Turco L, Traussnig H, Hakulinen P, Speck D, Von Wright A, Honkalampi-Hämäläinen U, Mäki-Paakkanen J, Severin I, Lhuguenot JC, Dahlman O. Test procedures for obtaining representative extracts suitable for reliablein vitrotoxicity assessment of paper and board intended for food contact. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:262-71. [DOI: 10.1080/02652030903232746] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Severin I, Dahbi L, Lhuguenot JC, Andersson MA, Hoornstra D, Salkinoja-Salonen M, Turco L, Zucco F, Stammati A, Dahlman O, Castle L, Savolainen M, Weber A, Honkalampi-Hämäläinen U, Von Wright A. Safety assessment of food-contact paper and board using a battery of short-term toxicity tests: European union BIOSAFEPAPER project. ACTA ACUST UNITED AC 2005; 22:1032-41. [PMID: 16227187 DOI: 10.1080/02652030500183425] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
An European Union (EU)-funded project QLK1-CT-2001-00930 (BIOSAFEPAPER) involves the development, validation and intercalibration of a short-term battery of toxicological tests for the safety assessment of food-contact paper and board. Dissemination of the results to industry, legislators (e.g. DG Consumer Protection, DG Enterprises, DG Research), standardization bodies such as CEN, and consumers will create an agreed risk evaluation procedure. The project involves pre-normative research in order to establish a set of in-vitro cytotoxicity and genotoxicity tests that will be easily adaptable to food-contact fibre-based materials and have endpoints relevant to consumer safety, including sub-lethal cellular events. These tests will be performed on samples representing actual migration conditions from food-contact paper and board with respect to different foodstuffs, and should form an experimental basis for scientifically sound recommendations for a harmonized system of risk evaluation and product testing.
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Affiliation(s)
- I Severin
- Université de Bourgogne, Food Toxicology Laboratory, Campus Universitaire, 1, esplanade Erasme, F-21 000 Dijon, France
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18
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Abstract
Sperm motility inhibition assay, earlier shown valuable for the detection of food poisoning non-protein toxins of Bacillus species was developed into an assay useful for specific detection of mitochondria damaging toxins. This was done by assessing the dissipation of the mitochondrial inner membrane transmembrane potential, Deltapsim under conditions where the plasma membrane permeability barrier remained intact. The Deltapsim was estimated as the intensity of orange JC-1 fluorescence in the mitochondrial sheath of the exposed spermatozoa. The plasma membrane integrity of the same cells was assessed by observing the exclusion of propidium iodide from the cytoplasm. Three types of mitochondrial toxic responses to microbially made bioactive substances were recognised. Mitochondrial toxicity by gramicidin (A, B, C, D), nigericin, salinomycin, narasin, monensin, calcimycin and antimycin A was characterised by gradual fading of the JC-1 fluorescence in the mitochondria. Dissipation of the Deltapsim by cereulide, valinomycin and enniatin (A, A1, B, B1) was visible as spotwise quenching of the mitochondrial JC-1 fluorescence. In addition these substances caused hyperpolarisation of the plasma membrane. Oligomycin (A, B, C), ionomycin and staurosporine inhibited the spermatozoan motility, but Deltapsim was fully preserved. Surfactin and lichenysin A caused mitochondrial damage at concentrations where the plasma membrane was also damaged.
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Affiliation(s)
- D Hoornstra
- University of Helsinki, Department of Applied Chemistry and Microbiology, Division of Microbiology, PO Box 56, FIN-00014 University of Helsinki, Finland
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