title: Activation of protein mediators of inflammation and evidence for endotoxemia in Borrelia recurrentis infection.
abstract: Fifteen patients with Borrelia recurrentis infection were studied to evaluate the role of certain plasma proteins and endotoxin in the pathophysiology of both the acute illness and the Jarisch-Herxheimer-like reaction. The causative spirochetes disappeared from the blood during the Jarisch-Herxheimer-like reaction, which occurred about 2 hours after antibiotic therapy. The mean titers of Hageman factor, plasma prekallikrein and serum hemolytic complement activity were decreased at the time of admission and 2 hours after treatment, and rose to normal values during convalescence. Serum properdin titers were decreased in 14 patients at the time of admission, in 12 patients 2 hours after treatment, and in none during convalescence. The frequency of elevated levels of fibrinogen-related antigens increased from three patients at the time of admission to 12 patients 2 hours after treatment. Results of plasma limulus tests for endotoxin-like material were positive in 11 patients at the time of admission and in 13 patients 2 hours after treatment. These findings demonstrated that Hageman factor, prekallikrein and proteins of the complement system are activated in B. recurrentis infection and that endotoxin may play a role in both the acute illness and in the development of the Jarisch-Herxheimer-like reaction after treatment.
mesh_terms: D000293:Adolescent; D000328:Adult; D000941:Antigens / Q000032:analysis; D001780:Blood Coagulation Tests; D002648:Child; D003165:Complement System Proteins / Q000378:metabolism; D004318:Doxycycline / Q000627:therapeutic use; D004731:Endotoxins / Q000097:blood*; D005174:Factor XII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000276:immunology; D006801:Humans; D008033:Limulus Test; D008297:Male; D008875:Middle Aged; D011288:Prekallikrein / Q000032:analysis; D011414:Properdin / Q000378:metabolism; D012061:Relapsing Fever / Q000097:blood* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000941:Antigens; D004731:Endotoxins; D011414:Properdin; D005174:Factor XII; D005340:Fibrinogen; D003165:Complement System Proteins; D011288:Prekallikrein; D004318:Doxycycline