2010 [Lesions of nervous systems in remote stages of Lyme borreliosis] Some is translated here. I have not translated the rest yet. You can copy and paste for your consideration. I will try to get it up later. -----------------------------------------------
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brain similar to those in MS. Data from Menenius are not obligate. A case autop- these patients with chronic progressiruyuschm encephalo- poliomyelitis with basal chronic leptomeningitom, ependimitom and leptomeningealnoy obliterans inflammatory vasculopathy with heart attacks in prodolgo- vatom brain [36]. The criterion in the diagnosis borrelioznogo en- tsefalomielita is the identification of inflammatory- application in CSF in the form of lymphocytic pleotsitoza, in augment the level of protein and intrathecal synthesis of IgM, IgG, IgA antibodies to Borrelia. According to J. Heller et al. [34], in patients with neuroborreliosis levels of IgM and cytosine in CSF is much greater than that of patients with MS. In addition, only patients with MS found intrate- by radical synthesis of antibodies to mumps, measles and Be- Tryan smallpox. Additional evidence in favor of borrelioznoy etiology encephalomyelitis is a half- HYDRATED or partial regression of symptoms against a background of pro- lation etiotropic antibacterial therapy. According to the National MS Society USA (Na- tional Multiple Sclerosis Sosiety), in the U.S. in endemic LB areas was carried out 2 studies identified- tion cases of neuroborreliosis among patients with a diagnosis probable MS. In the first investigation of a number of patients on Based on detection of antibodies to B.burgdorferi in blood and AGC, atypical changes on MRI and absence of oligo- clonal antibody diagnosis of MS was excluded in favor of Lyme disease. In the second - showed that only per unit ary cases of encephalomyelitis in patients with probable diagnosis of MS may be a manifestation neyroborrelio- favor. According to our data [3], the result of the used repetition among the 20 MS patients with positive ti- ters of antibodies to Borrelia in serum in only 1 (5,0%) patient with acute LB in history confirmed borrelioznaya etiology encephalomyelitis. In 7 (35,0%) seropositive for LB patients and moderately effective Volume of etiotrop treatment in the absence of intrate- cow, the synthesis of antibodies to B. burgdorferi had combina- tion of MS and chronic LB. In 12 (60,0%) patients with MS observed positive results in dynamic cal serological tests for LB were rastse- Nena as a false positive. Cerebral vasculitis manifested moderate metal- ningealnym syndrome, the development of ischemic stroke- Skog and less - on hemorrhagic tserebral- Mr. or spinal levels. Characterized by the development med- slowly progressive psychoorganic syndrome. Chronic radiculopathy (RP) occurs in 30 - 60% of patients in the later stages of LB [6, 8, 37, 40]. Its flow- tion in LB may be recurrent or progressive- pol. Isolated ER, no other characteristic symptoms are often regarded as a conse- interaction of degenerative spinal column. Pain- WIDE with RP often mark radicular pain or distal WIDE paresthesias in the extremities, persistent nature of pain- th syndrome, refractory to receive nonsteroidal pro- tivovospalitelnyh drugs. These patients often than in acute flow, identifies the symptoms of fallout- tion in the form of motor or sensory disorders. Also characteristic of a small manifestation of sym- ptomov miofiksatsii and limitation of movements in spine. RP at LB is also characteristic of the frequent co- chetanie these clinical manifestations with obschevos- palitelnym and asthenic syndromes, often de- press symptoms of dissemination LB, among which comes first defeat of the musculoskeletal apparatus (arthritis, arthralgia, myalgia). In chronic polyneuropathy patients brought by lyayut complaints of mild pain, paresthesia or weakness in the distal extremities. The distribution of sensitivity Indeed violations usually mosaic, or may localized distally and be as asymmetrical and symmetrical. Often there is a reduction or absence of tendon reflexes or easily pronounced WIDE paresis of limbs. According to electroneuromyography (ENMG), on- observed predominantly axonal damage ne- rifericheskih nerves with possible partial demieli- zation of proximal and distal segments. Ros- altruism [13] with ENMG-research patients with lesions of the PNC were discovered mosaic Pronounced changes of parameters, indicating the sub- clinically flowing mononevropa multi- TII in the absence of clinical signs of the latter. Y Y 56% of patients were found synchronized poten- Aly fastsikulyatsy indicating irritation moto neurons in the anterior horn of the spinal cord. When biopsy lymphocytic perivascular nerves there and plazmokletochnaya infiltration around epineural vessels of small and medium-caliber and epineural tissues. Furthermore, there is disseminated in lost by myelin fibers as a result of axonal de- generation [31]. According to our data [18], among 30 surveyed patients GOVERNMENTAL to chronic radikulopolinevropatiey all on- were observed sensory disorders, including for co- reshkovomu type - in 5 (16,7%), the combination of radicular and gauntlet-y 25 (83,3%). 21 (70,0%) persons from- Might paresthesias in the extremities, in 3 identified pain on ho- dy nerve trunks. Symptoms of tonic tension muscles and limitation of movements in the affected-by to the spine occurred in 22 (73,3%) patients. It should be noted that the severity of vertebral syn- Drom was negligible. Motor disturbances in form of lung distal paresis were found in 7 (23,3%) patients, moderate - in 3. Hypotrophy of muscle-struck tion limbs, muscle tone violation meeting- lis in isolated cases. Bannvarta syndrome was dia- gnostirovan in 3 patients. No expressed playback palitelnyh changes in CSF distinguishes neyroborreli- Lake in the territory of Russia from the European version of [6, 10, 33, 36]. The defeat of the National Assembly, only 9 (30%) patients were isolated in 21 (70%) it was combined with other sys- stemnymi manifestations, which is characteristic of chronic Skog LB [1]. Encephalopathy is one of the characteristic pro- phenomena of the late LB, often dominated in the clinical picture of the disease. In Russia, its frequency varies between 7 up to 76% in different regions [6, 7, 16, 17]. Manifestations encephalopathy in the LB are cognitive violation
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tion in the form of reduced concentration and memory, speech impairment as a difficulty selection of words and mi- kroochagovaya neurological siptomatika, violations psyche manifest themselves as depression, irritability, Reporting or paranoia. According to the implementation neyropsiho- logical tests, a decline of verbal and visual memory. These disorders, as well as the violation- shenie sleep greatly reduce the quality life of patients and can lead to permanent loss of labor- ability. Memory impairment may be secondary in relation to depression or chronic pain in patients with LB [37]. Often, clinical symptoms Encephalitides- shovels are not accompanied by inflammatory changes to developments in CSF. MRI revealed multifocal due Menenius white matter of the brain. According to our data [19], signs of encephalopathy late stages of LB were detected in 69,1% of patients. All of- celebrating its cognitive impairment, including a 24.1% pain- GOVERNMENTAL they were easy to get, at 48,3% - a moderate and by 27,6% - expressed. In 86% of patients cognitive violations combined with vestibuloatakticheskim syndrome- IOM and the pyramidal insufficiency, in 65.5% identified asthenic syndrome and in 92,8% - depression of varying degree. The mechanism of development entsefalopa- TII not fully understood. So far, it is not clear- Xia whether it is a consequence of infection and impact ekzotoksi- on synthesized borrelia, or associated with dysfunction- tsiey central nervous system due Pere�a hay before infection. Apparently, there are times- personal arrangements, since in some cases, the data manifests itself, leniya regressed on the background of antibacterial therapy, and some patients persist or appear after the treatment. Described such lesions in the NA neuroborreliosis, as as meningoentsefalomielopoliradikulonevropatiya, brain zhech kovye disorder, transverse myelitis, an extra- pyramidal disorders. An interesting case of atypical neuroborreliosis with the main complaint about the increasing bloating as a result of denervation of the lower thoracic and rectus abdominis. Cases of two-way On the defeat of the optic nerve, postbulbar non- Writ, an isolated hypoglossal nerve neuropathy. Y Y of patients found symptoms of irritation, vegetative cy ganglia and a wide range of autonomic reactions tions [25, 33, 36, 45]. The defeat of the other organs and systems in LB In the later stages of LB characterized by symptoms of dissociation crimination infection with lesions in various organs and systems [1, 9, 15, 44, 45]. Cutaneous marker for generalized- Bathroom dissemination LB are secondary erythema. Pathognomonic signs of disseminated for- we disease is pseudolymphoma. For deter- her skin manifestation of LB - chronic atrophic acrodermatitis. In addition, late-stage illness tion identifies various nonspecific skin symptoms: erythematous rash, skin Vasco LIT, livedo. The defeat of the heart develops in 1-10% of patients with disseminated LB. Lyme carditis may be- Xia clinical and ECG signs of myo-or-perikar Dita, moderate heart failure, but naib- Lee characterized the blockade of conductive paths, of which more common atrioventricular block. Violation tion rate for Lyme disease is noted in 20-25% of cases teas. Be recorded seizures supraventricular and ventricular arrhythmia, extrasystoles, episodes Mertz tive arrhythmias. One of the most common manifestation of su- shutters syndrome in LB are arthralgia, which observed in 27-35% of cases. In the acute period, they fre- hundred are local to the place tick tick. In-In reflection of muscles in the form of myalgia occurs in 11-55% of patients, GOVERNMENTAL LB. Often they are combined with lesions of peripheral- cal NA, manifested myositis. Typical manifestations tion of articular syndrome in LB is Lyme arthritis, which can occur already in the acute period of illness. The most characteristic of mono-or oligoarthritis with the involvement- eat large joints, usually the knee. Less typical are reflection of small joints of hands and feet. Characteristic symptoms, concomitant Lyme arthritis, are different manifestations of lesions of periarticular tissues (tendinitis, tendovaginitah, bursitis, enthesiopathies, tallalgii and ossalgii), cyst Becker. With the defeat of the eyes in 10-15% of patients found conjunctivitis, which is usually accompanied by fever early stage. Described as periorbital edema, uveitis, keratitis, episcleritis, iritis, chorioretinitis, panof- Talma. In patients with chronic LB sometimes once- pare progressive keratitis with focal infiltration tration of the cornea. In 15-19% of patients have symptoms of lesions, tion of the liver. The most common diagnosis is exposed only Based on changes in liver function tests - transaminase elevations or the appearance of direct bilirubin. In 5% of the patients described in the kidney as hematuria and proteinuria, revealed by the micro- microscopy of urine sediment. Diagnosis Diagnosis of LB is based on epidemiological skih symptoms, clinical picture and confirmed by direct or indirect laboratory methods determine infection B.burgdorferi [15, 16, 28, 36, 45]. Tests to detect antigens of Borrelia has not found wide application in diagnostic prac- Re. PCR to investigate the CSF of patients neyroborrelio- Thus superior to the sensitivity of cultural, but inferior to serological testing. Sensitivity Nosta PCR diagnostics for early LB is 25 - 30%, and the chronic - 10%. The main disadvantage of PCR - A large number of false-negative results. Serological methods are based on the definition of spe- crystallographic immune response to antigens B.burgdorferi. To diagnose the disease most often use- yutsya indirect immunofluorescence reaction (NRIF) immunosorbent assay (ELISA), as well as immunnoblot (Western-blot). In the U.S. and Europe over the last decade widely used two-step method serodiagnosti- ki. The main screening test in this scheme is ELISA. The test samples with positive or with- hypochondriac results in ELISA necessarily addi- Indeed tested by immune blotting. By Sozh- leniyu, a two-step approach for serodiagnosis borreliosis little use in our country
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Page 1 90 90 Journal of Neurology and Psychiatry, 2, 2010 Journal of Neurology and Psychiatry, 2, 2010 REVIEWS REVIEWS Lyme borreliosis (Lyme disease tick-borne disease, Lai-Lyme borreliosis (Lyme disease tick-borne disease, Lai ma, LB) - infectious multiple organ prirodnoochago-ma, LB) - infectious multiple organ prirodnoochago- howling of vector-borne diseases caused by howling of vector-borne diseases caused by is the spirochete Borrelia burgdorferi sensu lato. is the spirochete Borrelia burgdorferi sensu lato. Disease-Disease- tion is different phasic flow and systemic pro-tion is different phasic flow and systemic pro- phenomena in the process may involve the skin, skeletal-phenomena in the process may involve the skin, musculoskeletal skeletal and nervous system, heart, liver, skeletal and nervous system, heart, liver, eyes. eyes. Vector of the disease are ixodid Vector of the disease are ixodid mites. mites. Their spontaneous infection with Borrelia in Their spontaneous infection with Borrelia in natural foci of 10-70%, mixed Ying-foci of 10-70%, mixed in- ductive with the virus of tick-borne encephalitis - up to 15%. ductive with tick-borne encephalitis - up to 15%. From 7 From 7 - 9% to 24-50% of ticks in endemic foci may be - 9% to 24-50% of ticks in endemic foci may be infected simultaneously with two or three different infected simultaneously with two or three different Borrelias [11, 12]. Borrelias [11, 12]. The reservoir of the causative agent and "bread--The reservoir of the causative agent and" eat for mitelyami "ticks are many species of small mammals-mitelyami" ticks are many species of small mammals melting, hoofed animals and birds [12]. melting, hoofed animals and birds [12]. The main clinical manifestations of the disease-The main clinical manifestations of It is known from the late XIX - early XX century. It is known from the late XIX - early XX century. Migratory Erie-Migratory Erie Subject (DOE), was described in 1909 by Afzelius in 1913 Theme (DOE), was described in 1909 by Afzelius in 1913 Lipschutz. Lipschutz. The case of ME with the subsequent development of metal-The case of ME with the subsequent development of metal- ningita was described in 1930 Hellestromom. ningita was described in 1930 Hellestromom. The first case-First case Teas syndrome Bannvarta, meningoradikulonevropatii, Teas syndrome Bannvarta, meningoradikulonevropatii, which developed after the tick tick and ME, which developed after the tick tick and ME, were reported Gare and Bouillaud in 1922, in 1944 - Bannvar-were reported Gare and Bouillaud in 1922, in 1944 - Bannvar- vol. vol. In 1960 Shaltenbrand and other European In 1960 Shaltenbrand and other European neuroscientists have studied large cohorts of patients with pain neuroscientists have studied large cohorts of patients with pain radikulonevropatiey, neuropathy of cranial nerves or radikulonevropatiey, neuropathy of cranial nerves or lymphocytic meningoencephalitis, developing-lymphocytic meningoencephalitis, developing Xia due tick tick. Xia due tick tick. Intensive studied-Intensive-studied tion of LB began only with the 1970. tion of LB began only with the 1970. following descriptions following descriptions U.S. Alan Steer Lyme arthritis and the opening of Willy US Alan Steere Lyme arthritis and the opening of Willy Burgdorferom causative agent. Burgdorferom causative agent. Series after-Series of after- lowing investigations have demonstrated aetiological lowing investigations have demonstrated aetiological commonality of all of the above syndromes. commonality of all of the above syndromes. So So obvious that LB - widespread zoonosis, and obvious that LB - widespread zoonosis, and a huge part of its territory nozoareala have a huge part of its territory has nozoareala � team of authors, 2010 � team of authors, 2010 Zh Nevrol Psikhiatr Im SS Korsakova 2010; 110:2:90 Zh Nevrol Psikhiatr Im SS Korsakova 2010; 110:2:90 e-mail: [email protected] e-mail: [email protected] The defeat of the nervous system to the remote stages of Lyme-The defeat of the nervous system to the remote stages of Lyme borreliosis borreliosis MD MD NS NS Baranov, prof. Baranova, prof. NN NN Spirin, EG Spirin, EG Shipov, IO Thorns, IO Stepanov Stepanov Lesions of the nervous systems in remote stages of Lyme borreliosis Lesions of the nervous systems in remote stages of Lyme borreliosis NS BARANOVA, NN SPIRIN, EG SHYPOVA, IO STEPANOV NS BARANOVA, NN SPIRIN, EG SHYPOVA, IO STEPANOV Department of Nervous Diseases and Medical Genetics, with the rate of Neurosurgery, Yaroslavl State Medical Academy, Department of Nervous Diseases and Medical Genetics, with the rate of Neurosurgery, Yaroslavl State Medical Academy Key words: Lyme borreliosis, encephalomyelitis, encephalopathy, cerebral vasculitis, radikulopolinevropatiya, Key words: Lyme borreliosis, encephalomyelitis, encephalopathy, cerebral vasculitis, radikulopolinevropatiya, neuroborreliosis. neuroborreliosis. Key words: Lyme-borreliosis, encephalomyelitis, encephalopathy, cerebral vasculitis, radiculopolyneuropathy, neuroborreliosis. Key words: Lyme-borreliosis, encephalomyelitis, encephalopathy, cerebral vasculitis, radiculopolyneuropathy, neuroborreliosis. Russia, coinciding with the centers of dissemination of tick-borne Russia, coinciding with the centers of dissemination of tick-borne viral encephalitis [12, 14, 36, 45]. viral encephalitis [12, 14, 36, 45]. Currently Currently Lyme borreliosis is included in the ICD-10 codes A69.2 under - Lyme borreliosis is included in the ICD-10 codes A69.2 under - Lyme disease. Lyme disease. Epidemiology Epidemiology The disease is widespread throughout the world, The disease is widespread throughout the world, but especially big problem for Health-but especially big problem for Health- Guard of the Northern Hemisphere, including Ros-Guard of the Northern Hemisphere, including Ros- these. these. In Russia, the highest incidence In Russia, the highest incidence takes place in the Tomsk region (71.6 per 100 thousand population-takes place in the Tomsk region (71.6 to 100 thousand popula- tion), Kirov, Kostroma, Perm, Vologda tion), Kirov, Kostroma, Perm, Vologda areas of the Republic of Udmurtia, Komi-Permyak and areas of the Republic of Udmurtia, Komi-Permyak and Ust-Orda Buryat autonomous districts (21,0 - Ust-Orda Buryat autonomous districts (21,0 - 38,0 per 100 thousand population) [11, 12]. 38,0 per 100 thousand population) [11, 12]. The defining features of the epidemiology of early The defining features of the epidemiology of early LB coincide with those for tick-borne encephalitis LB coincide with those for tick-borne encephalitis (TBE). (TBE). The maximum rise in the incidence of LB noting-The maximum rise in the incidence of LB-Noting etsya in June - July, sporadic cases of illness they-etsya in June - July, sporadic disease, those ploy autumn and recorded in September - October. ploy the fall recorded in September - October. LB LB occurs in persons of all age groups, but more often Beau-occurs in persons of all age groups, but more often Beau leyut persons of working age (30-59 years), the share leyut persons of working age (30-59 years), the share which accounts for 45% of cases, about 10% of cases-which accounts for 45% of cases, about 10% of cases, children [43]. children [43]. Etiology and Pathogenesis Etiology and Pathogenesis Borrelia burgdorferi is morphologically with-Borrelia burgdorferi is morphologically with- fight gram spiral, which has a 7-11 ne-fight gram spiral, which has a 7-11 ne- riplazmaticheskimi flagella, capable of active riplazmaticheskimi flagella, capable of active translational and rotational motions. translational and rotational motions. Availability Availability flagella and the mobility of Borrelia consider major flagella and the mobility of Borrelia consider major condition of its invasiveness. condition of its invasiveness. Borrelia have multiple Borrelia have multiple groups of antigens: surface (OspA, OspB, OspD, groups of antigens: surface (OspA, OspB, OspD, OspF), flagellar and cytoplasmic. OspF), flagellar and cytoplasmic. Proteins which are off-Proteins which are off- dyaschiesya on the outer shell, determine the species in-dyaschiesya on the outer shell, determine the species in- nadlezhnost pathogen and are the primary immuno-nadlezhnost pathogen and are the primary immuno- Page 2 Page 2 91 91 Journal of Neurology and Psychiatry, 2, 2010 Journal of Neurology and Psychiatry, 2, 2010 nogenami. nogenami. Many of the antigenic determinants of foreign Many of the antigenic determinants of foreign membrane similar to those of other Borrelia species and membrane similar to those of other Borrelia species and some other microorganisms (especially with T.pal-some other microorganisms (especially T.pal- lidum, agents of tick-borne relapsing fever), which lidum, agents of tick-borne relapsing fever), which explains the possibility of cross-immunological explains the possibility of cross-immunological reactions [21, 45, 47]. reactions [21, 45, 47]. Genetically group Borrelia burgdorferi is a com-Genetically group Borrelia burgdorferi is a com- complexes genospecies B.burgdorferi sensu lato. complexes genospecies B.burgdorferi sensu lato. American, American, European and Asian isolates differ from each other-European and Asian isolates differ from each other ha on the morphology, the nature of the surface membrane protein-ha on the morphology, the nature of the surface membrane proteins branes, plasmids and homologous DNA, which is n-branes, plasmids and homologous DNA, which is n- kinetic basis. kinetic basis. More than 10 genomic groups More than 10 genomic groups B.burgdorferi sensu lato, unequally represented in the time-B.burgdorferi sensu lato, unequally represented in the time- different geographic areas. different geographic areas. For human pathogens For human pathogens only Borrelia burgdorferi sensu stricto, Borrelia garinii, and only Borrelia burgdorferi sensu stricto, Borrelia garinii and Borrelia afzelii [12, 45, 47]. Borrelia afzelii [12, 45, 47]. There is evidence that individual-There is evidence that individual WIDE genomic groups in turn are connected with the definition-WIDE genomic groups in turn are connected with the deter- lennymi clinical manifestations of LB. lennymi clinical manifestations of LB. Thus, infected-Thus, infected with mation B.burgdorferi sensu stricto genospecies associate-mation genospecies B.burgdorferi sensu stricto associate etsya with a primary lesion of skeletal-etsya with a primary lesion of support- apparatus, genospecies B. apparatus, genospecies B. garinii - with the defeat garinii - with the defeat nervous system (NS), who also B. nervous system (NS), who also B. afzelii - with skin afzelii - with skin syndromes of LB. syndromes of LB. On the territory of Russia are determined On the territory of Russia are determined mainly B. mainly B. garinii and B.afzelii [12, 16, 31, 45]. garinii and B.afzelii [12, 16, 31, 45]. As part B.burgdorferi discovered more than 100 proteins As part B.burgdorferi discovered more than 100 proteins (Lipoprotein), the biological significance of the majority (Lipoprotein), the biological significance of most is unknown. is unknown. The ratio of-The ratio of- vidual surface proteins varies even Borre-vidual surface proteins varies even Borrie ly one genospecies. ly one genospecies. Especially is variable content Especially is variable content surface proteins OspA and OspC. surface proteins OspA and OspC. The highest n-The highest n- terogennost protein composition detected in B.garinii terogennost protein composition detected in B.garinii (By OspA - 7, OspC - 13 options) and B.afzelii (for OspA (By OspA - 7, OspC - 13 options) and B.afzelii (for OspA - 2, OspC - 8). B.burgdorferi sensu stricto differs constant - 2, OspC - 8). B.burgdorferi sensu stricto differs con- yanstvom spectrum of surface proteins. yanstvom spectrum of surface proteins. Differences in their with-Differences in their co- composition and content rise to particular biological-composition and content rise to particular biological optical properties of Borrelia, which leads to different manifests itself-optical properties of Borrelia, which leads to different manifests itself, leniyu pathological reactions from makroorga-leniyu pathological reactions from makroorga- nism. nism. Known atypical forms of Borrelia - cysto-, Known atypical forms of Borrelia - cysto-, granulovidnye and giant, assuming that the image-granulovidnye and giant, assuming that education tion of atypical forms contributes to the survival of spiro-tion of atypical forms contributes to the survival of spiro- hat and chronic forms of the disease [27, 47]. hat and chronic forms of the disease [27, 47]. The leading role in the pathogenesis of LB is infection. The leading role in the pathogenesis of LB is infection. After the tick tick and getting into the skin of Borrelia After the tick tick and getting into the skin of Borrelia people they interact with many factors-people they interact with many fac- tori protection microorganism, which are causing-tori protection microorganism, which are causing, ly as a pathological process in the place of persistence ly as a pathological process in the place of persistence pathogen, and a common response to infection. pathogen and a common response to infection. In the process of phagocytosis is the death of Borrelia, in re-In the process of phagocytosis is the death of Borrelia, in re- result, which included specific mechanisms of-result, which included specific mechanisms im munnoy protection [27]. munnoy protection [27]. Borrell disseminiruet in the skin, you-Borrell disseminiruet in the skin, you- zyvaya local inflammatory reaction, and then penetrating-zyvaya local inflammatory reaction, and then penetrating em in the other organs and tissues. em in the other organs and tissues. In the initial period of the disease In the initial period of illness Borrelia can be detected in the skin, blood and cerebro-Borrelia can be detected in the skin, blood and spinal cerebrospinal fluid (CSF), in small numbers - in the cerebrospinal fluid (CSF), in small numbers - in sites infarction, retinal, muscle, bone, liver, brain-sites infarction, retinal, muscle, bone, liver, brain, noncircular shells and brain. noncircular shells and brain. Immune response triggered in response to B. Immune response triggered in response to B. burgdorferi, are of great importance in the pathogenesis of LB. burgdorferi, are of great importance in the pathogenesis of LB. Thus, Thus, interaction with mononuclear phagocytes you-interaction with mononuclear phagocytes you- svobozhdayutsya mediators of inflammation, in particular, cyto-svobozhdayutsya mediators of inflammation, in particular, cyto- kina. kina. In in vitro studies demonstrated that In in vitro studies demonstrated that spirochete is a potent inducer factor spirochete is a potent inducer factor FNO-α (TNF) interleukin-1β (ИЛ1β), tumor necrosis-α (TNF), interleukin-1β (ИЛ1β), interleukin-6 (IL6), and others involved in the process of-interleukin-6 (IL6), and others involved in the process in reflection of the joints and the National Assembly, they may be important in the patho-reflection of the joints and the National Assembly, they may be important in the patho- genesis of sleep disorders and the development of syndrome fibromial-genesis of sleep disorders and the development of syndrome-fibromial gies. gies. Levels of TNF and ИЛ1β have a tendency to reduction-Levels of TNF and ИЛ1β have a tendency to reduction- tion as the transition from acute illness to a protracted tion as the transition from acute illness to a protracted and chronic periods, whereas the concentrations of IL6 and chronic periods, whereas the concentrations of IL6 - Increases. - Increases. In addition, in acute pain in LB-In addition, in acute pain in LB- GOVERNMENTAL followed becomes chronic disease states bou-GOVERNMENTAL followed becomes chronic disease states bou- Lee high content ИЛ1β and lower Lee high content ИЛ1β and lower TNF and IL6 than patients with a subsequent get well-TNF and IL6 than patients with a subsequent get well- tion [15, 33, 45]. tion [15, 33, 45]. Higher concentrations of CRP was encountered in 40% Higher concentrations of CRP was encountered in 40% patients in the early stages of LB [2]. patients in the early stages of LB [2]. High antibody titer High antibody titer serum to Borrelia was higher in patients with you-serum to Borrelia was higher in patients with you- sokoy CRP. sokoy CRP. It is possible that high UB-It is possible that high uro- Wen CRP with neuroborreliosis reflects a more pronounced-Wen CRP with neuroborreliosis reflects a more pronounced s 'immune response and is associated with velocity-s' immune response and is associated with velocity Ration elimination of Borrelia from the bloodstream and tissues. Ration elimination of Borrelia from the blood and tissues. Cellular immunity in response to antigens B. Cellular immunity in response to antigens B. burgdorferi is formed early and is aimed at the destruction burgdorferi is formed early and is aimed at the destruction spirochetes. spirochetes. In patients with LB decreased suppressor-In patients with LB decreased suppressor- tion and natural killer activity, which can tion and natural killer activity, which could be an important mechanism for spirochetes dis-be an important mechanism for spirochetes dis- seminirovat. seminirovat. A special feature of immune response in LB A special feature of the immune response in LB The delay of humoral response to antigens The delay of humoral response to antigens B. B. burgdorferi. burgdorferi. The peak of the immune response lies between the third and The peak of the immune response lies between the third and 6-weeks of the beginning of infection [27]. 6-weeks of the beginning of infection [27]. Humoral them-Humoral im immunities with Lyme disease, first presented IgM en-immunities with Lyme disease, first presented IgM en- Titel, then within a few weeks developed Titel, then within a few weeks developed specific IgG response. specific IgG response. Progression of-Progression for- diseases the spectrum of antibodies to many proteins of diseases the spectrum of antibodies to many proteins Borrelia. Borrelia. This indicates a possible crossing-This indicates a possible crosse Mr. response of the immune system with antigens of Bor-Mr. response of the immune system with antigens of Bor- rely and microorganism with subsequent formation rely and microorganism with subsequent formation autoimmune mechanisms. autoimmune mechanisms. The leading role in this conquer-The leading role in this conquer- ditsya longer persistence of the virus in tissues and ditsya longer persistence of the virus in tissues and its intracellular location [30, 33, 37]. its intracellular location [30, 33, 37]. Local immune response in LB is significantly Local immune response in LB expressed much stronger than the total [35 36, 38]. stronger than the total [35, 36, 38]. In the CSF accumulates In CSF collected Th1-cell memory, capable of differentiation into ef-Th1-cell memory, capable of differentiation into ef- fektornye cells. fektornye cells. In the CSF of patients found to increase in-In the CSF of patients found to increase tion of not only CD4 + T-lymphocytes, and ticks-tion of not only CD4 + T-lymphocytes, and cellular Current expressing CD8 +, HLA-DR + receptor, as well-Current expressing CD8 +, HLA-DR + receptor, as well same B-lymphocytes and natural killer cells. same B-lymphocytes and natural killer cells. In the initial phase of the disease are of great importance In the initial phase of the disease are of great importance CD8 + T-lymphocytes. CD8 + T-lymphocytes. During this period of the disease in the CSF During this period of the disease in the CSF indicate an increase in CD8 (+) T cells that are determined-indicate an increase in CD8 (+) T cells that are determined divided by type of cellular receptor (β), as well as the Express-divided by type of cellular receptor (β), as well as express- compensating receptors to 5 CC chemokines and CD69. compensating receptors to five CC chemokines and CD69. Lowering-Lowering- tion to the level observed in the process of healing. tion to the level observed in the process of healing. At At neuroborreliosis in the CSF showed an increased den-neuroborreliosis in the CSF showed an increased den- dritnyh cells with a phenotype (CD11c (+) CD123 (dim)) mi-dritnyh cells with a phenotype (CD11c (+) CD123 (dim)) mi- eloidnogo and plasmocytic (CD11c (-) CD123 (high)) eloidnogo and plasmocytic (CD11c (-) CD123 (high)) origin [35]. origin [35]. Infiltration of lymphocytes and dendritic cells Infiltration of lymphocytes and dendritic cells through the blood-brain barrier (BBB) is regulated through the blood-brain barrier (BBB) is regulated chemokines, whose concentration in CSF is much you-chemokines, whose concentration in CSF is much you- more than in plasma. more than in plasma. Increased concentration of macrophages-Increased concentration of macrophages, galnogo inflammatory protein-1β, monocytes heh-galnogo inflammatory protein-1β, monocytes heh motaksicheskogo protein-1, 3, RANTES, stromal factor-motaksicheskogo protein-1, 3, RANTES, stromal factor mation of normal cells-1α. mation of normal cells-1α. A role in the penetration A role in the penetration Borrelia and lymphocytes in the CSF is matrix metal-Borrelia and lymphocytes in the CSF is matrix metal- CNS in Lyme borreliosis CNS in Lyme borreliosis Page 3 Page 3 92 92 Journal of Neurology and Psychiatry, 2, 2010 Journal of Neurology and Psychiatry, 2, 2010 talloproteinaza-9 [5, 46]. talloproteinaza-9 [5, 46]. According to our data, dysfunction-According to our data, dysfunction- tion of BBB, activation or damage to the endothelial tion of BBB, activation or damage to the endothelial cells involved in the collection of Borrelia and lymphocyte cells involved in the collection of Borrelia and lymphocytes through the BBB [2], as evidenced by the increase in the concentration-through the BBB [2], as evidenced by the increasing concentration concentration in the serum von Willebrand factor in concentration in the serum von Willebrand factor in 35,7% of patients with neuroborreliosis. 35,7% of patients with neuroborreliosis. In these patients, CSF In these patients, CSF there is a significant increase in the level of soluble there is a significant increase in the level of soluble forms one of the cell adhesion molecules - ICAM-1, forms one of the cell adhesion molecules - ICAM-1,
-------------------- Suspected Lyme 07 Test neg One band migrating in IgG region unable to identify.Igenex Jan.09IFA titer 1:40 IND IgM neg pos 31 +++ 34 IND 39 IND 41 IND 83-93 + DX:Neuroborreliosis Posts: 5850 | From Kentucky | Registered: Dec 2008
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Pinelady
Frequent Contributor (5K+ posts)
Member # 18524
posted
This is the continuation of what was already translated. I though it interesting esp. the terminology.
-------------------- Suspected Lyme 07 Test neg One band migrating in IgG region unable to identify.Igenex Jan.09IFA titer 1:40 IND IgM neg pos 31 +++ 34 IND 39 IND 41 IND 83-93 + DX:Neuroborreliosis Posts: 5850 | From Kentucky | Registered: Dec 2008
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posted
Sounds like they are doing important work. Too bad it is published in Russian. Did you know the bumsteere went over there to mislead them? Maybe they figured this out? Or some did anyway.
Posts: 8430 | From Not available | Registered: Oct 2000
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