Yale 2000: Possible implications of multiple variants for Lyme disease persistence.

1: Rheumatology (Oxford). 2000 May;39(5):537-41. Related Articles,
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Geographic clustering of an outer surface protein A mutant of Borrelia
burgdorferi. Possible implications of multiple variants for Lyme
disease persistence.

Malawista SE, Montgomery RR, Wang XM, Fu LL, Giles SS.

Department of Internal Medicine, Yale University School of Medicine,
New Haven, CT 06520-8031, USA.

DNA sequences encoding full-length outer surface protein (Osp) A were
amplified from four joint fluid samples over 4.5 months from a patient
with chronic Lyme arthritis, with a variant from wild type only found
in sample 3. Rather than a mutation in vivo, these findings suggested a
mixed infection in which BORRELIA: containing the wild-type and mutant
ospA were waxing and waning in the patient's joint. If so, we reasoned
that the mutant should be present in the community. We therefore took
the novel epitope resulting from the mutation, expressed as a fusion
protein in Escherichia coli, and performed Western blots on 80
high-titred stored sera; however, all except that of our index patient
were negative. We then collected 36 stored sera from patients with Lyme
disease residing within 10 miles of where the index patient had lived.
An additional two sera from this circumscribed area were positive (P =
0.038). These findings show that results from single samples can be
misleading, and suggest that the OspAs expressed in force late in Lyme
arthritis are the same ones introduced initially into the host.
Moreover, they allow a speculative mechanism for disease persistence
not previously considered, in which antigenically distinct B.
burgdorferi variant proteins present themselves serially to the immune
system.

PMID: 10852986 [PubMed - indexed for MEDLINE]

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