博氏螺旋体病——最新的鉴定技术和世界范围的发病率

Iuliana Vlădoiu, A. Munteanu, Mihaela Surcel
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摘要

“由受感染的蜱虫引发的莱姆病每年在美国影响30多万人,在欧洲每年影响6.5万人,主要发生在春季和夏季。早期症状发烧、头痛和疲劳,如果不及时治疗,可能演变为关节痛、面瘫、头痛伴颈部僵硬、心悸。此外,约10 - 20%的患者将继续发展数月/数年的关节疼痛,记忆问题和疲劳。来自各大洲的人类与蜱虫相互作用,这种相互作用是通过联系蜱虫种群丰度、病原体流行率和已登记的人类疏螺旋体病来间接测量的。由感伯氏疏螺旋体引起的莱姆伯氏疏螺旋体病是北半球记录的最广泛的蜱传感染。诊断始于对受感染患者的临床评估,并辅以实验室检测。FDA于2019年发布的建议建议采用两种测试方法,作为第一种测试方法,该方法基于敏感酶免疫测定(EIA)(可用免疫荧光测定替代),然后是western免疫印迹(WB)测定阳性或模棱两可的结果。这些测试有几个下降点,因此专注于使用各种蛋白质组学/代谢组学/基因组技术进行早期感染鉴定,这些下降点可以被超越。伯氏疏螺旋体有几种蛋白质可以参与宿主的免疫反应。由于新的预防方法可以减少这种广泛传播疾病的发病率,鉴定可用于开发新疫苗的保护性表位变得势在必行。”
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BORRELIOSIS – UP-DATES IN IDENTIFICATION TECHNOLOGIES AND WORLD-WIDE INCIDENCE
"Lyme disease triggered by infected ticks can affect over 300,000 people/ year in USA and 65,000 people/ year in Europe mainly in spring and summer. The early symptoms fever, headache and tiredness can evolve if left untreated in joint pains, facial paralysis, headaches with neck stiffness, heart palpitations. Moreover about 10 - 20% of patients will continue to develop months/years to come joint pains, memory issues and tiredness. Humans from all the continents interact with ticks and this interaction is measured indirectly, by relating tick population abundance, pathogen prevalence, and registered human borreliosis. Lyme borreliosis caused by bacteria of the Borrelia burgdorferi sensu lato species, is the most widespread tick-borne infection registered in the northern hemisphere. Diagnostics starts with the clinical evaluation of the infected patient and is complemented by laboratory testing. FDA recommendation published in 2019 recommend a two-test methodology, as a first test the methodology is based on sensitive enzyme immunoassay (EIA) (replaceable with an immunofluorescence assay), followed by a western immunoblot (WB) assay for positive or equivocal results. These tests have several down -falls thus focusing on using various proteomic/metabolomic/genomic technologies for early stages of infection identification these down-falls can be surpassed. Borrelia burgdorferi has several proteins that can be involved in the hosts immune response. Identification of protective epitopes that could be used to develop a new vaccine becomes imperative as new prophylactic methods can reduce the incidence of this wide-spread disease."
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