Association of distinct species of Borrelia burgdorferi sensu lato with neuroborreliosis in Switzerland

Abstract

OBJECTIVE: To evaluate by species-specific immunoblots the association of Borrelia burgdorferi sensu stricto, B. garinii and B. afzelii with neuroborreliosis in Switzerland. METHODS: Borrelia strains isolated from the cerebrospinal fluid (CSF) of three children with neuroborreliosis were typed by phenotypic and genotypic analysis. The serologic reactions (IgG) of these three patients as well as those of 28 patients, including one of these three children, with confirmed neuroborreliosis were characterized and scored by immunoblots on the three individual Borrelia species antigens. Twenty patients with typical erythema migrans served as a control group. RESULTS: Phenotypic and genotypic analysis confirmed that all three CSF isolates were B. garinii. In the 28 patients with neuroborreliosis, the comparatively strongest reactions were as follows: 18 to B. garinii, three to B. burgdorferi sensu stricto and two to B. afzelii; five were inconclusive. In the control group (erythema migrans), the comparatively strongest reactions were as follows: six B. garinii, one to B. burgdorferi sensu stricto and five to B. afzelii; eight were indeterminate. CONCLUSIONS: Typing of these three CSF isolates and characterization by immunoblots of the antibody reactions of patients with neuroborreliosis give additional evidence of the association of B. garinii and neuroborreliosis. Our serologic results suggest that B. burgdorferi sensu stricto and B. afzelii are also responsible for some neuroborreliosis cases in Switzerland. Our immunoblots and the scoring system proved particularly useful for the serologic typing of patients with late Lyme borreliosis.

PCR-Reverse Line Blot Typing Method Underscores the Genomic Heterogeneity of Borrelia valaisiana Species and Suggests Its Potential Involvement in Lyme Disease

“…The PCR-RLBA method was therefore used to analyze 18 cases of neuroborreliosis. The results showed that most patients had been infected with B. garinii (13 out of 18 patients [ Table 4]), in agreement with previous observations showing the preferential association of this genospecies with neurological complications (8,30,27). Moreover, the PCR-RLBA analysis revealed several cases of multiple infection (Table 1).…”

“…To date only B. burgdorferi sensu stricto, B. garinii, and B. afzelii are known to be responsible for causing human disease (2,7,27,30). In fact, it seems that infections with B. burgdorferi sensu stricto tend to lead to arthritic symptoms, while those with B. garinii appear to cause neurological complications.…”

Specificities and Sensitivities of Four Monoclonal Antibodies for Typing of Borrelia burgdorferi Sensu Lato Isolates

“…neuroborreliosis are more frequently infected with B. garinii (8) or present serological reactions in accordance with this association (1,2,24,29). We have previously reported serological evidence for a pathogenic potential of B. valaisiana in humans (29).…”

“…For example, different reservoir hosts were described for some Borrelia species (13)(14)(15). Similarly, several reports have suggested an association of particular clinical symptoms in human with some Borrelia species (1,2,10,24,29). The typing of B. burgdorferi sensu lato isolates is essential to clarify this specific point and consequently to understand the physiopathology of each Borrelia species (12,17,21).…”

“…In Europe, five genospecies have been described from the original B. burgdorferi, now called B. burgdorferi sensu lato: B. burgdorferi sensu stricto, B. garinii, B. afzelii, B. lusitaniae, and B. valaisiana (3, 9, 19, 32 (1,2,24,29). We have previously reported serological evidence for a pathogenic potential of B. valaisiana in humans (29).…”