md-medicaldata

Authors

 

Elizabeta Ristanović¹, Sonja Atanasievska¹, Vesna Protić-Đokić¹, Nataša Hinić², Dušan Lalošević<sup>2

1</sup>Vojno medicinska akademija, Odeljenje za mikrobsku genetiku i imunologiju Instituta za mikrobiologiju
²Medicinski fakultet u Novom Sadu, Pasterov zavod Novi Sad

 

Rad je primljen 30.07.2017. / Prihvaćen 24.08.2017

 

Correspondence to

Prof. dr Elizabeta Ristanović,
Vojnomedicinska akademija
Beograd, Crnotravska 17,
e-mail: elizabet@eunet.rs

 

 

Abstract

 

Lyme borreliosis is a multi-system disease caused by Borrelia burgdorferi, which is transmitted by hard ticks Ixodes spp. The most common clinical manifestation is the skin lesion (erythema migrans), however there is a tendency of the pathogen to spread and cause damages to the joints, nervous and cardiovascular system. The diagnosis of Lyme disease is based primarily on clinical findings, epidemiological and anamnestic data and laboratory test results. The application of the modern real-time PCR method allows us to test the skin in tick bite area for a presence of B. burgdorferi. In the diagnosis of Lyme disease, we often use indirect methods (TIIF, ELISA, Western blot) for detecting specific IgM and IgG antibodies against B. burgdorferi in serum, liquor and synovial fluid. To confirm the diagnosis, the presence of IgG antibodies should be demonstrated, since the presence of IgM is not a relible indicator of a recent infection. When interpreting immunodiagnostic test results it has to be considered that there are a lot of variability as the phenotype characteristics of borrelia, different antigenic structures, different geographical distribution, phase varies in duration of the disease, characteristics of individual immune responses, presence of other diseases as well as the applied antibiotic treatment, which all can affect the outcome. Due to the high presence of infected ticks in our geographical area, it is necessary to provide continuous preventive measures, epidemiological monitoring and improvement of the diagnostic and therapeutic approach in the treatment of Lyme borreliosis.

 

 

 

Key words:

Lyme borreliosis, Borrelia burgdorferi, PCR method, Serological tests

 

 

Sažetak

 

Lajmska borelioza predstavlja multisistemsku bolest izazvanu Borreliom burgdorferi, čiji su glavni prenosioci krpelji Ixodes spp. Najčešća klinička manifestacija je u vidu kožne lezije (erythema migrans), međutim patogen se može širiti i prouzrokovati oštećenja zglobova, nervnog i kardiovaskularnog sistema. Dijagnoza lajmske bolesti postavlja se na osnovu kliničke slike, epidemiološko-anamnestičkih podataka i rezultata laboratorijskih dijagnostičkih testova. Primena savremene real-time PCR metode omogućava nam testiranje dela kože sa mesta uboda krpelja na prisustvo B. burgdorferi. Takođe, u dijagnostici lajmske bolesti često se koriste i indirektne metode za određivanje specifičnih IgM i IgG antitela na B. burgdorferi prisutnih u serumu, likvoru i sinovijalnoj tečnosti (TIIF, ELISA, Western blot). Za potvrdu dijagnoze trebalo bi dokazati prisustvo IgG antitela, jer samo prisustvo IgM antitela nije siguran pokazatelj nedavne infekcije. Prilikom interpretacije imunodijagnostičkih testova treba uzeti u obzir fenotipske karakteristike borelija, njihove različite antigenske strukture, različite geografske rasprostranjenosti, fazu i dužinu trajanja bolesti, karakteristike individualnog imunskog odgovora, eventualno prisustvo drugih oboljenja kao i primenjeni antibiotski tretman. Zbog visokog prisustva zaraženih krpelja na našem geografskom području, neophodna je kontinuirana prevencija, epidemiološko praćenje, kao i unapređenje dijagnostičkog i terapijskog pristupa u lečenju lajm-borelioze.

 

 

Ključne reči:

Lajmska borelioza, Borrelia burgdorferi, PCR metoda, Serološki testovi

 

 

References

 

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PDF Ristanović E. et al. • MD-Medical Data 2017;9(3): 143-147