title: Target imbalance: disparity of Borrelia burgdorferi genetic material in synovial fluid from Lyme arthritis patients.
abstract: 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 (PCR) 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 was found exclusively in clinical specimens and not in cultured organisms. The physiologic imbalance of genomic and plasmid DNA reactivity in B. burgdorferi infection may signal an underlying pathogenetic mechanism.
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
authors.forename: D H
authors.initials: DH
authors.lastname: Persing
authors.forename: B J
authors.initials: BJ
authors.lastname: Rutledge
authors.forename: P N
authors.initials: PN
authors.lastname: Rys
authors.forename: D S
authors.initials: DS
authors.lastname: Podzorski
authors.forename: P D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: K D
authors.initials: KD
authors.lastname: Reed
authors.forename: B
authors.initials: B
authors.lastname: Liu
authors.forename: E
authors.initials: E
authors.lastname: Fikrig
authors.forename: S E
authors.initials: SE
authors.lastname: Malawista
mesh_terms: D000942:Antigens, Bacterial; D000954:Antigens, Surface / Q000235:genetics; D001170:Arthritis, Infectious / Q000382:microbiology*; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D001428:Bacterial Vaccines; D001483:Base Sequence; D015748:Borrelia burgdorferi Group / Q000235:genetics*; D004269:DNA, Bacterial / Q000032:analysis*; D006801:Humans; D008074:Lipoproteins; D008193:Lyme Disease / Q000382:microbiology* / Q000503:physiopathology; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000382:microbiology*
chemical_list: D000942:Antigens, Bacterial; D000954:Antigens, Surface; D001425:Bacterial Outer Membrane Proteins; D001428:Bacterial Vaccines; D004269:DNA, Bacterial; D008074:Lipoproteins; C072045:OspA protein; C077030:OspB protein, Borrelia burgdorferi