Target Imbalance: Disparity of Borrelia burgdorferi Genetic Material in Synovial Fluid from Lyme Arthritis Patients

• Published in: The Journal of infectious diseases Vol. 169; no. 3; pp. 668 - 672
• Main Authors: Persing, David H., Rutledge, Barbara J., Rys, Paul N., Podzorski, Diane S., Mitchell, Paul D., ,, Kurt D. Ree, Liu, Bing, Fikrig, Erol, Malawista, Stephen E.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-03-1994; University of Chicago Press
• Subjects: Antigens, Bacterial; Antigens, Surface - genetics; Arthritis, Infectious - microbiology; Bacterial diseases; Bacterial Outer Membrane Proteins - genetics; Bacterial Vaccines; Base Sequence; Biological and medical sciences; Borrelia burgdorferi; Borrelia burgdorferi Group - genetics; Borrelia infections; Concise Communications; DNA; DNA, Bacterial - analysis; Genomes; Genomics; Human bacterial diseases; Humans; Infectious diseases; Lipoproteins; Lyme disease; Lyme Disease - microbiology; Lyme Disease - physiopathology; Medical sciences; Molecular Sequence Data; Plasmids; Polymerase Chain Reaction; Ribosomal DNA; Sensitivity and Specificity; Specimens; Synovial fluid; Synovial Fluid - microbiology; Tropical bacterial diseases; Human; Lyme disease; Borrelia burgdorferi; Spirochaetaceae; Spirochaetales; Nucleotide sequence; Pathogenesis; Diseases of the osteoarticular system; Borrelia infection; Arthritis; Infection; Polymerase chain reaction; Synovial fluid; Microbiological investigation; DNA; Bacteriosis; Bacteria; Spirachaetosis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/169.3.668

Lyme arthritis is a late manifestation of Lyme disease that results in episodic synovial inflammation and swelling. Although this process is thought to be driven directly by the spirochetal etiologic agent, Borrelia burgdorferi, the organism itself has been recovered by culture only twice. In contrast, polymerase chain reaction (peR) studies are usually positive. This apparent discrepancy in 19 culture-negative synovial fluid specimens from 18 patients with Lyme arthritis was investigated. In all 19,DNA sequences characteristic of plasmid-encoded genes OspA and OspB were easily detected. However, despite equivalent or even superior analytic sensitivity for detection of cultured organisms, the reactivity of two genomic DNA targets was often weak or absent altogether in the clinical specimens. This apparent overrepresentation of B. burgdorferi plasmid sequences wasfound exclusively in clinical specimensand not in cultured organisms. The physiologic imbalance of genomic and plasmid DNA reactivityin B. burgdorferi infection may signal an underlying pathogenetic mechanism.