title: Cellular and molecular aspects of Lyme arthritis.
abstract: Lyme disease is a multisystem illness initiated upon infection with the spirochete Borrelia burgdorferi. Whereas the majority of patients who develop Lyme arthritis may be successfully treated with antibiotic therapy, about 10% go on to develop arthritis which persists for months to years, despite antibiotic therapy. Development of what we have termed treatment-resistant Lyme arthritis has previously been associated with both the presence of particular major histocompatibility complex class II alleles and immunoreactivity to the spriochetal outer surface protein A (OspA). Recently, we showed that patients with treatment-resistant Lyme arthritis, but not patients with other forms of arthritis, generate synovial fluid T cell responses to an immunodominant epitope of OspA and a highly homologous region of the human-lymphocyte-function-associated antigen-1alphaL chain. Identification of a bacterial antigen capable of propagating an autoimmune response against a self-antigen provides a model of molecular mimicry in the pathogenesis of treatment-resistant Lyme arthritis.
authors.affiliation: Department of Pathology, Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Gross
authors.forename: B T
authors.initials: BT
authors.lastname: Huber
mesh_terms: D000942:Antigens, Bacterial / Q000276:immunology; D000954:Antigens, Surface / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology; D001428:Bacterial Vaccines; D015748:Borrelia burgdorferi Group / Q000276:immunology / Q000502:physiology; D004351:Drug Resistance; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D008074:Lipoproteins; D008193:Lyme Disease / Q000276:immunology* / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D022123:Lyme Disease Vaccines / Q000276:immunology; D016169:Lymphocyte Function-Associated Antigen-1 / Q000276:immunology; D018448:Models, Immunological; D018716:Molecular Mimicry
chemical_list: D000942:Antigens, Bacterial; D000954:Antigens, Surface; D001324:Autoantigens; D001425:Bacterial Outer Membrane Proteins; D001428:Bacterial Vaccines; D006680:HLA Antigens; D008074:Lipoproteins; D022123:Lyme Disease Vaccines; D016169:Lymphocyte Function-Associated Antigen-1; C072045:OspA protein