title: [Pathogenetic-clinical problems of Lyme borreliosis].
abstract: In this article a short review of pathogenesis and clinical manifestations of Lyme disease is presented. As regards pathogenesis, attention was paid to the mosaic protein structure of the B. burgdorfieri spirochete, particularly of outer surface proteins (Osp) that influence the clinical course and diagnosis of the disease. The presence of various atypical spirochete forms: spheroplastic L (without cell walls), cystic, and granular "blebs" may lead to a chronic form of the disease and to a low efficacy of antibiotic therapy. An important part of the pathogenesis is epithelial damage, stimulating the production of inflammatory cytokines (mainly IL-1, TNF-alpha, IFN-gamma), adhesive molecules and acute-phase proteins. Moreover, in the course of the disease not only an impairment of phagocytosis and chemotaxis was found, but also B. burgdorfieri spirochete binding by antibodies into immunological complexes that may maintain chronic inflammation. In terms of the Asbrink classification, complaints predominating in the clinical picture of an early and late stage of the disease were presented, with an emphasis on neuroborreliosis.
authors.affiliation: Kliniki Chorób Zakaźnych i Neuroinfekcji, AM w Białymstoku.
authors.forename: Teresa
authors.initials: T
authors.lastname: Hermanowska-Szpakowicz
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Zajkowska
authors.forename: Sławomir A
authors.initials: SA
authors.lastname: Pancewicz
authors.forename: Maciej
authors.initials: M
authors.lastname: Kondrusik
authors.forename: Sambor S
authors.initials: SS
authors.lastname: Grygorczuk
authors.forename: Renata
authors.initials: R
authors.lastname: Swierzbińska
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D025065:Borrelia burgdorferi; D057167:Claudins; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology; D007375:Interleukin-1 / Q000276:immunology; D008193:Lyme Disease / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism; D009419:Nerve Tissue Proteins / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; C120453:CLDN11 protein, human; D057167:Claudins; D007375:Interleukin-1; D009419:Nerve Tissue Proteins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma