Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects

Abstract

Lyme Borreliosis, or Lyme’s disease, manifests itself in numerous skin conditions. Therapeutic intervention should be initiated as soon as a clinical diagnosis of erythema migrans is made. The histopathology of some of the skin conditions associated with Lyme Borreliosis is characterised by structural changes to collagen, and sometimes also elastic fibres. These conditions include morphea, lichen sclerosus et atrophicus and acrodermatitis chronica atrophicans. More recently, further skin conditions have been identified by the new microscopic investigation technique of focus floating microscopy: granuloma annulare, necrobiosis lipoidica, necrobiotic xanthogranuloma, erythema annulare centrifugum, interstitial granulomatous dermatitis, cutaneous sarcoidosis and lymphocytic infiltration; these conditions also sometimes cause changes in the connective tissue. In the case of ligaments and tendons, collagen and elastic fibres predominate structurally. They are also the structures that are targeted by Borrelia. The resultant functional disorders have previously only rarely been associated with Borreliosis in clinical practice. Ligamentopathies and tendinopathies, spontaneous ruptures of tendons after slight strain, dislocation of vertebrae and an accumulation of prolapsed intervertebral discs as well as ossification of tendon insertions can be viewed in this light.

New records of the Lyme disease bacterium in ticks collected from songbirds in central and eastern Canada

“…In particular, B. burgdorferi-infected I. scapularis can initiate Lyme disease in humans causing a myriad of symptoms (Cameron et al 2014;Adrion et al 2015). Without early or adequate treatment, Lyme disease patients may develop a latent infection because spirochetes will invade and lodge in immune-privileged sites and deep-seated tissues, such as tendons and ligaments (Häupl et al 1993;Müller 2012), brain (Oksi et al 1996;MacDonald 2007;Miklossy 2011), bone (Oksi et al 1994;Fein and Tilton 1997), muscle (Frey et al 1998), eye (Preac-Mursic et al 1993, glial and neuronal cells (Ramesh et al 2008(Ramesh et al , 2013 and fibroblasts/scar tissue (Klempner et al 1993). In these secluded niches, B. burgdorferi can flourish and, a clinically non-apparent infection, can progress to manifest disease due to the combined effects of a persistent infection and the ensuing inflammatory responses.…”

“…East of the Rockies, Lyme disease spirochetes have been detected in four Ixodes species (Ixodes affinis, Ixodes dentatus, Ixodes muris, Ixodes scapularis) (Scott et al 2001, 2012, Oliver et al 2003). The first live culture of B. burgdorferi collected from a bird in Canada was isolated from an I. scapularis (nymph) in Nova Scotia during cross-border, spring migration (Scott et al 2001).…”

Established Population of Blacklegged Ticks with High Infection Prevalence for the Lyme Disease Bacterium, Borrelia burgdorferi Sensu Lato, on Corkscrew Island, Kenora District, Ontario

“…As the zoonosis advances, spirochetes produce neurotoxins that induce inflammatory cytokines (i.e., interleukin 1, interleukin 6, TNF-alpha) 78, 79, and can result in mitochondrial dysfunction, oxidative stress, and physical and hormonal abnormalities 79, 80. If left untreated or inadequately treated, B. burgdorferi s.s. will sequester and persist in deep-seated tissue, including brain 81-83, bone 84, collagenous tissues (ligaments, tendons) 85, 86, eye 87, glial and neuronal cells 88, 89, muscle 90, and fibroblasts/scar tissue 91. Since B. burgdorferi s.s. is pleomorphic, treatment must take into account diverse forms (i.e., spirochetes, round bodies, blebs, granules); collectively, they form slime-coated, polysaccharide matrices, called biofilms 92.…”

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“…Borrelia can break down substances within the ECM and can form micro colonies in collagen fibers [21,[22][23][24]. Another study showed that Plasmincoated B. burgdorferi could enter and reside in tissues and that the spirochete preferred the interstitial ECM of colonized tissues [25].…”

“…Another study showed that Plasmincoated B. burgdorferi could enter and reside in tissues and that the spirochete preferred the interstitial ECM of colonized tissues [25]. Tendons and ligaments are a structurally and topographically ideal retreat for Borrelia which may contribute to the chronic nature of the illness [21]. Culturing Borrelia from human blood in vitro has proven to be challenging for the most astute scientists.…”